Impaired metabolism was a key factor in the definition of ischemic penumbra. 1H-MRSI has been recognized as a potentially powerful tool for metabolic imaging of stroke. In this proof of concept clinical study, we explored the potential of fast 3D high-resolution 1H-MRSI to investigate brain neurometabolic changes at tissue-level in acute stroke. In a 6-min scan, we obtained N-acetylaspartate (NAA) and lactate (Lac) maps simultaneously. Our experimental results showed different NAA and Lac concentrations between hypoperfused tissue recruited to final infarct and that survived, indicating an improved delineation of penumbra by incorporating the tissue neuronal damage and acidosis information.