Abstract: Objective：To assess the diagnostic value of proton magnetic resonance spectroscopy (1H-MRS) in preterm infants with hypoxic ischemic encephalopathy (HIE). Methods：Twenty-eight preterm infants with HIE and 45 normal preterm infants of the same gestational age and birth weight were included. All infants underwent 1H-MRS scanning using Ge Signal 1.5T MR Scanner. The 1H-MRS diagram was calculated by GE workstation functool software, and N-acetyl aspartate (NAA)/creatinine (Cr), NAA/choline (Cho) and lactic acid (Lac)/Cr in right basal ganglia were measured. Statistical analyses of the parameters were performed by independent-samples t-test. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off values for NAA/Cho, NAA/Cr, and Lac/Cr in right basal ganglia. Sensitivity and specificity were reported for the optimal thresholds. Results：In preterm infants with HIE, NAA/Cho, NAA/Cr in the right basal ganglia were significantly lower than those in normal preterm infants (P<0.05). Lac/Cr in the right basal ganglia was significantly higher than that in normal preterm infants (P<0.01). The cut-off values of NAA/Cho=0.57 and NAA/Cr=1.07 provided the best combination of sensitivity (63.2%, 89.5%, respectively) and specificity (81.5%, 55.6%, respectively). The cut-off value of Lac/Cr = 0.09 also provided the best combination of sensitivity (89.5%) and specificity (88.9%). Conclusions：1H-MRS parameters such as NAA/Cho, NAA/Cr, and Lac/Cr in right basal ganglia could play important roles in diagnosing preterm infants with HIE.