31P-MR-Spectroscopy was performed in 28 patients with focal (n = 23) and diffuse (n = 5) liver disease and in 18 healthy volunteers. The spectra were obtained with a whole body scanner operating at 1.5 T by using a surface coil. To get T1-weighted 31P-spectra a short TR of 600 msec was taken, because T1-weighted spectra of focal liver disease were more significantly different from spectra from healthy volunteers than density weighted ones. The VOI from patients with focal superficial alterations showed a mean volume of 172 ml, with diffuse liver disease 196 ml, and from volunteers 158 ml. Focal tumors filled up the VOI on an average of 70%. This investigation demonstrated that PME β-ATP- and PDE β-ATP-ratios were sensitive indicators for focal liver disease. As a result of this study we could establish a significant increase of PME β-ATP- (0.75 ± 0.30) and PDE β-ATP-ratios (1.68 ± 0.62) in patients with superficial focal liver metastases (n = 19) compared to the control group ( PME β-ATP: 0.49 ± 0.17, PDE β-ATP: 1.24 ± 0.24; t-test: p < 0.02). Patients with a hemangioma (n = 1), liver infarction (n = 1), empyema of gallbladder (n = 1) and a hepatic involvement by a malignant lymphoma (n = 1) showed a similar increase of PME β-ATP and/or PDE β-ATP. Up to now spectral changes seemed to be non-specific. The ratios of 31P metabolites of the cirrhoses (n = 4) and the fatty liver (n = 1) did not show any characteristic changes versus the volunteers.