MR spectroscopy is a non-invasive technique for measuring tissue metabolites. Changes in tissue metabolites may be useful for diagnosing or characterizing primary and other brain neoplasms, planning treatment, and assessing the results of treatment. Ongoing improvements in equipment and pulse sequence design may make full brain spectroscopy clinically practical in the near future. The authors review the basic concepts of MR spectroscopy and its use in clinical management of brain neoplasms.