Proton magnetic resonance spectroscopy (1H-MRS) and neuropsychological assessment were utilized in a longitudinal investigation of traumatic brain injury (TBI) in children. A spectroscopic imaging protocol was implemented, and neurometabolite ratios of NAA/Cre and Cho/Cre were calculated for anterior and posterior halves of a supraventricular slab of brain tissue. NAA/Cre was reduced and Cho/Cre increased in TBI patients as compared to controls, for both brain regions. Each ratio predicted aspects of neuropsychological performance, though the specific relationships varied somewhat by region and function. Anterior NAA/Cre increased and anterior Cho/Cre decreased from 3 to 21 weeks post-injury, suggesting neurometabolic recovery.