A new method for image-guided localized phosphorus NMR spectroscopy of superficial tissues has been investigated using a 1.5 Tesla whole-body-MR-System. We used a surface coil combined with adiabatic excitation pulses and a modified ISIS sequence. This approach is related to imaging sequences and thus permits a flexible and accurate determination of the volume of interest from "conventional" proton images. The scope and advantages of the method are demonstrated by phantom studies. Clinical applications to the liver, renal transplants, and the mediastinum are described.