Metabolic derangements have been identified in various cardiac pathologies and, vice versa, many metabolic disorders may lead to a cardiac phenotype. MRS provides a noninvasive window to investigate the metabolic pathogenesis of cardiomyopathies and to assess treatment response at an early stage of intervention. Facilitated by ongoing developments, multinuclear cardiac MRS has contributed significantly to preclinical and clinical research efforts to elucidate the role of disturbed myocardial metabolism in the etiology of cardiomyopathies. In this educational, we highlight the major applications and results, and discuss recent methodological advancements and remaining challenges towards applications of cardiac multinuclear MRS.