AbstractNow that both magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) have reached their decadic majority, appropriate questions may be asked as to their accomplishments and prognostications for the future. This article emphasizes the approach of the metabolic biologists/physiologists to magnetic resonance biochemistry as indicated by the currently available multinuclear localized approaches. The viewpoint is emphasized that MRS is a critical care instrument where precipitious changes of oxidative metabolism lead to the well‐known stroke, heart failure, liver failure, kidney failure, etc. Generally, the gradation between the classical metabolic steady state of life and the pathway leading to cell death is a narrow one and magnetic resonance in some cases is too finely tuned to delineate the gradations of stability and instability of cell metabolism. To this point, magnetic resonance can be supplemented by other modalities that sense tissue distress. An example of a most useful and predictive measure of hypoxic stress is optical spectrophotometry which uses time resolved ranging methods to measure optical path lengths to quantitate hemoglobin deoxygenation in tissues. With such a complement, the two methods emerge as one of general importance in diagnostic procedure