To evaluate the role of magnetic resonance spectroscopy imaging (MRSI) parameters to predict early biochemical recurrence (BCR) after radical prostatectomy (RP) in patients with non-metastatic prostate cancer (PCa). Between November 2010 and March 2012, 60 consecutive patients with clinically non-metastatic biopsy confirmed PCa underwent RP after MRSI assessment in a prospective study. Demographic, clinicopathological, magnetic resonance imaging (MRI) staging, MRSI parameters, and postoperative serum prostate-specific antigen were recorded. The univariate and multivariate Cox regression analyses were used to assess the association between potential prognosticators and early BCR (BCR less than 12 months after RP). In univariate Cox regression, preoperative serum PSA (prostate-specific antigen) (HR – hazard ratio = 1.016, p=0.003), surgical Gleason score > 7 (HR = 5.034, p=0.006) and MRSI risk score (HR = 4.061, p=0.0001); and in multivariate model, preoperative serum PSA (HR = 1.012; p=0.046), surgical GS > 7 (HR = 4.196; p=0.017) and MRSI risk score (HR = 3.256; p=0.013) were associated with early BCR. The greatest AUC (area under the curve) was related to MRSI risk score (AUC = 0.733) and the AUC of the multivariate model was 0.776. MRI/MRSI parameters specially MRSI risk score might be acceptable predictors of early BCR. These parameters can improve the accuracy of predictive nomograms to assess the risk of BCR after RP.