Recent breakthroughs enabling the hyperpolarization of biologically interesting compounds containing 13C are revolutionizing the ways we image metabolism in vivo. Unlike positron-emission tomography (PET), hyperpolarized 13C magnetic resonance (MR) spectroscopic imaging not only detects the injected 13C-labeled metabolite but also its downstream products through chemical shifts in the measured MR spectra. This new molecular imaging technique allows quantitative assessment of flux along the metabolic pathways and hence, complements the PET findings. Hyperpolarized 13C metabolic imaging has shown promise in elucidating metabolic changes in cancer cells and animal studies, supporting the concept considering cancer as a metabolic disease with the metabolic shifts enforced by oncogenes and tumor suppressors. The first-in-human hyperpolarized 13C imaging study was conducted recently in prostate cancer patients, confirming the clinical potential of this remarkable technology. There is considerable debate about prostate cancer management and watchful waiting may be the answer for many patients in whom disease is likely to be inactive. However, 18FDG-PET is not effective in prostate cancer due to low tumor uptake and the diagnostic tools needed to predict disease aggressiveness are lacking, making patient-specific therapy difficult. This presentation will cover the basic principle of hyperpolarized 13C imaging technique and its applications in prostate cancer diagnosis and treatment monitoring.