Traumatic brain injury (TBI) causes extensive damage to the white matter (WM) of the brain, which can be evaluated with diffusion-weighted magnetic resonance imaging (dMRI). Diffusion MRI can be used to map the WM tracts and their integrity, but offers limited understanding of the biochemical basis of any differences. Magnetic resonance spectroscopy (MRS) measures neural metabolites that reflect neuronal health, inflammation, demyelination, and other consequences of TBI. We combined whole-brain MRS with dMRI to investigate WM dysfunction following pediatric TBI, using “tract-based spectroscopy”. Deficits in N-acetylaspartate (NAA) correspond to regions of deficits in WM integrity, but choline showed minimal overlap with WM deficits. NAA is a marker of neuronal health, while choline is an inflammatory marker. A partial F-test showed that MRS measures improved our ability to predict long-term cognitive function. This is the first paper to combine MRS with dMRI-derived tracts on a whole-brain scale, offering insights into the biochemical correlates of WM tract dysfunction, following injury and potentially in other WM disorders.