Background: Spinal cord myelopathy can happen due to cord compression in variable situations. Understanding biochemical and metabolic changes in myelopathy are needed to expect treatment outcomes. The non-invasive technique of 1H-MRS can provide data about chemical microenvironment related to tissue metabolic changes by measuring of N-acetylaspartate (NAA), choline (Cho), and creatine (Cr) [1-8]. Aim of Study: The aim of current study is to evaluate the diagnostic value of 1H-MRS in the assessment of biochemical changes in cervical spondylotic myelopathy. Subjects and Methods: 26 subjects with cervical myelopathy and 12 volunteers who were age-matched with no neurological problems were considered as control group. MR spectroscopy was done and analysis of MRS to detect NAA (2.0ppm), Cho (3.25ppm), Cr (3.03ppm) and Lactate (Lac) (1.32ppm). Recording of NAA/Cr as well as Cho/Cr were done. Results: Detection of peak of Lactate was possible in 10 patients; however no lactate peak was noted in the members of control group. The NAA/Cr ratio was recorded and comparison was done between patient and control group and showed significant difference as the mean NAA/Cr in control subjects equaled 1.87±0.05 versus 1.33±0.057 for patient group (p<0.0001) (figure 2-6). Furthermore mean NAA/Cr ratio in subjects with lactate peak was lower than that in patients without such peak (1.268±0.028 versus 1.365±0.034) with significant difference (p<0.0001) . There was no significant difference between the mean Cho/Cr ratio in patient group and control group (mean =0.783±0.065 versus 0.764±0.049, p=0.38) Also the mean ratio of Cho/Cr of lactate peak patients was not significantly different from those without lactate (0.79±0.074 versus 0.77±0.061, p= 0.44). Conclusion: MRS can provide good data about the metabolic changes in patients with cervical spondylotic myelopathy (CSM)