The aim of this study to assess the neurometabolites changes foundin patients with lacunar infarction patients and their relation to theirpsychometric performance.This study was carried out on 30 patients diagnosed as havingsymptomatic lacunar infarction (18 males and 12 females). Their agesranged between 45-75 years with a mean age of 59.13 ± 9.5 years. Patientsin this study were subjected to full clinical neurological, clinicalneuropsychological, MRI and H’MRS assessment.The results of this study showed that H’MRS superior to structuralMRI as detect neurometabolic changes in brain after lacunar infarction.Shows significant positive correlation between NAA and psychometric testresults.