This study examined magnetic resonance spectroscopy (MRS) as a potential biomarker for chronic traumatic encephalopathy (CTE). 79 former National Football League players and 23 same-age controls completed MRS. Cumulative head impact index (CHII) estimated repetitive head impact (RHI) exposure. Principal component analysis derived clinical composites. Former NFL players had lower parietal white matter (PWM) NAA (p=0.048). Higher CHII predicted lower PWM creatine (p=0.028). Anterior cingulate gyrus (ACG) metabolites correlated with visual memory (p=0.008-0.044). ACG glutamate (p=0.032) and glutamate/glutamine (p=0.012) predicted psychomotor/executive function. Posterior cingulate gyrus myo-inositol predicted verbal memory (p=0.048). MRS may facilitate detection of RHI-related neurological conditions, including CTE.