Objective Through the analysis of diffusion tensor imaging (DTI) combined 1 H magnetic resonance spectroscopy (1H-MRS) in neonatal hypoxic-ischemic encephalopathy (HIE) in the diagnostic results, thus providing an accurate reference for clinical diagnosis in patients with HIE. Methods Select the hospital 90 cases of HIE, as observed in this study group, select another period of 90 cases of normal deliveries healthy newborns in the control group for the study. Both groups were 1 H-MRS and DTI scans and radiographic images were compared, measured two choline (Cho), N-acetyl aspartate (NAA), creatine (Cr), lactate (LAC), myo-inositol (MI), glutamate and glutamine (GluGln) and other metabolites, and then compared. Results The inspection found that one of the control group had no abnormal signal DTI; observation group, using DTI HIE were detected for 76 cases, 84.4% diagnostic accuracy was significantly higher than normal MRI detected in 39 cases (43.3%), a statistically significance, P<0.05. Observation group of children NAA/Cr was significantly lower than the control group, while Cho/Cr, MI/Cr and Clu+Cln/Cr, Lac/Cr was significantly higher, the difference was significant, P<0.05. Conclusion DTI may HIE clinical applications for early detection and effective display of its range and the number of lesions, while using 1 H-MRS can noninvasively measuring brain tissue hypoxia in children, metabolites produced during ischemia, a combination that can increase the risk of children clinical diagnostic accuracy for patients to provide strong prognostic value.