Deep cerebral white matter (CWM) like the centrum semiovale is vulnerable to ischemic injury. Brain temperature (BT) was associated with cerebral hemodynamic abnormalities in patients with chronic ischemia. We investigated whether the BT distribution map by multi-voxel 1H-MRS were associated with the cerebral hemodynamic abnormalities assessed by positron emission tomography (PET) in the CWM region of patients with unilateral chronic major cerebral artery steno-occlusive disease. The BT map quantitatively and qualitatively correlated with PET images, especially oxygen extraction fraction. This may help to identify the patients at high risk for the stroke recurrence.