To explore the value of in vivo 31phosphorus magnetic resonance spectroscopy (31PMRS) in detection of musculoskeletal metabolism for patients with liver cirrhosis. Methods31PMRS scanning with a single voxel on thigh skeletal muscle was carried out in 31 patients with liver cirrhosis and in 30 normal cases. Intracellular pH value (pHi) and some metabolic parameters including phosphomonoester (PME), phosphodiester (PDE), inorganic phosphate (Pi), phosphocreatine (PCr), γATP, βATP, αATP, and the ratios of Pi/ATP, PCr/ATP, PCr/PME, PCr/PDE, PCr/Pi, PME/ATP, PME/PDE, PME/Pi, PDE/ATP, and PDE/Pi were calculated. Influences of liver cirrhosis and ChildPugh stage on skeletal muscle were analyzed. Results31PMRS showed an increase of PME, PCr, βATP, PME/PDE, and Pcr/PDE in liver cirrhosis patients when compared with the controls, whereas the PDE/ATP was the reverse(P<0.05). The musculoskeletal pHi in ChildPugh stage A, B and C was 7.18±0.10, 7.20±0.10, and 7.41±0.08, respectively, and in PME/PDE was 0.57±0.26, 0.68±0.24, and 1.16±0.24 respectively, which were statistically different (P<0.05). No differences in others parameters were found (P>0.05). Conclusion31PMRS may be used to noninvasively evaluate abnormal musculoskeletal metabolism caused by liver cirrhosis, and the musculoskeletal pHi and PME/PDE increase with the ChildPugh stage.