Objective: To review the basic theory of magnetic resonance spectroscopy (MRS) and its application on stroke by recent overseas situation of researching on the basic theory of MRS and its application on stroke. Data sources: We searched Medline for pertinent literature on the basic theory of MRS and its application on stroke published from 1990 to 2005, with the key words "Magnetic Resonance Spectroscopy, Stroke", "Magnetic Resonance Spectroscopy, Metabilism", and limited the language to English. Study selection: After the first selection, the related literatures on MRS and its application on stroke were collected, and the obvious nonrandomized researches on clinical trial were excluded, and the rest literatures were searched for the full text. Inclusion criteria: Randomized controlled clinical trial, no matter single blind, double blind or non-blind method. Data extraction: Totally 28 related articles were collected. Ten articles on repetitive researches were excluded, and the rest 18 articles were reviewed. Data synthesis: Of the 18 articles, there were 78 cases. The basic theory of MRS was indicated. The classification and significance of resonance peak of brain 1H-MRS and the application of MRS in cerebral infarction were recommended. The change condition of metabolite in brain during cerebral infarction was summed up. It was thought that the fluctuation of lactic acid, high-energy phosphate and pHi had certain regularity. The content of lactic acid in the infarcted focus had relation with volume of infarcted focus, regional cerebral blood flow and score of clinical neural function. Conclusion: The application of MRS can observe the changes of metabolism in internal brains of patients with stroke, know the severity degree of patients' condition, and suspect on prognosis of cerebral infarction.