A new MR methodology, hyperpolarized MR spectroscopy (MRS), enhances the MRS signals by more than a factor 10,000, enabling fast and unique insight into in situ metabolic processes. So far the method has provided new and exciting metabolic details in prostate, heart, brain, kidney and liver examinations. In diseases characterized by abnormal metabolic profiles, such as in diabetes and tumour tissue, hyperpolarized MRS provides highly detailed spatial information as well as quantitative estimates of individual steps in glycolysis and real-time amino acid metabolism.