Objective: This study aimed to evaluate the value of magnetic resonance spectroscopy (MRS) in the differential diagnosis of gliomas, meningiomas, and brain metastatic tumors.Methods: A total of 102 patients with pathologically confirmed intracranial tumors were enrolled and divided into three groups: the glioma group (n=44), the meningioma group (n=30), and the metastatic tumor group (n=28). All patients underwent 3.0T magnetic resonance imaging (MRI) and MRS examinations, including single-voxel and multi-voxel spectroscopy sequences. The metabolite ratios (choline compounds/N-acetylaspartate [Cho/NAA], choline compounds/creatine [Cho/Cr], N-acetylaspartate/creatine [NAA/Cr], (lipid+lactate)/creatine [(Lip+Lac)/Cr], and peritumoral relative choline ratio [rCho/Cr]) in the tumor parenchyma and peritumoral edema regions were analyzed.Results: There were significant differences in the metabolite ratios of the parenchyma region among the three tumor groups (P<0.001). The glioma group had the highest Cho/NAA and Cho/Cr ratios, the metastatic tumor group had the highest (Lip+Lac)/Cr ratio, and the meningioma group had the highest NAA/Cr ratio. The rCho/Cr ratio in the peritumoral edema region of the glioma group was significantly higher than that of the other two groups (P<0.001). Receiver operating characteristic (ROC) curve analysis showed that peritumoral rCho/Cr and tumor Cho/NAA had high diagnostic efficacy in distinguishing high-grade gliomas (HGG) from solitary metastatic tumors (SM) (with areas under the curve (AUC) of 0.876 and 0.892, respectively). The consistency of the measurement results between the two physicians was good (intraclass correlation coefficient (ICC) > 0.85).Conclusion: MRS can effectively reflect the metabolic characteristics of different types of brain tumors, and exhibits superior differential diagnostic value especially in the analysis of rCho/Cr in the peritumoral edema region. It can provide important imaging evidence for clinical preoperative differentiation.