PURPOSE: To evaluate the usefulness of hydrogen-1 magnetic resonance (MR) spectroscopy in the evaluation of the developing brain. MATERIALS AND METHODS: Localized MR spectra were obtained with an echo time of 272 msec from the brain of 78 neonates and infants aged 1 week to 100 months. All patients were retrospectively classified into three groups on the basis of neurologic development: abnormal (group 2, n = 21), normal despite minor neurologic signs (group 1, n = 23), and normal (group 0, n = 34). RESULTS: Seventeen patients in group 2 and eight patients in group 1 revealed abnormally low N-acetylaspartate (NAA)/choline or NAA/creatine ratios compared with those obtained in group 0. MR spectroscopy was slightly more useful in the differentiation of patients in groups 2 and 1 (x2 test, P &lt
.005) than MR imaging (P &lt
.01). CONCLUSION: H-1 MR spectroscopy provides prognostic information about the brain in healthy and neurologically damaged infants and augments the value of MR imaging.