Abstract: By using hyperpolarized ¹³C labeling technology, the magnetic resonance signals of ¹³C-labeled metabolic substrates are enhanced, which enables the in vivo monitoring of their metabolic states through magnetic resonance spectroscopy. Compared with traditional non-invasive metabolic diagnostic technologies, hyperpolarized ¹³C technology exhibits a number of strengths, including real-time monitoring, high precision, non-invasiveness, the absence of radiation, and the ability to assess a broader range of metabolic pathways, showing great potential for application in the treatment of glioma, stroke, Alzheimer disease, and cerebral injury. Following the approval of 1-¹³C-pyruvate for clinical trials by U.S. Food and Drug Administration (FDA), there has been growing academic interest in this technology. Currently, the primary challenge lies in creating more probes and promoting their clinical applications. Herein, we outlined the principles of hyperpolarized ¹³C labeling technology, examined its current role in neurological metabolic diagnostics, and explored the future directions, including conducting hyperpolarized ¹³C magnetic resonance spectroscopy (MRS) technology at higher magnetic field strengths (such as 7T), designing additional magnetic resonance sequences specific to hyperpolarized ¹³C MRS, and its integration with other neuro-metabolic diagnostic methods.