Deficits in Complex I (NADH-ubiquinone oxidoreductase) of the electron transport chain may play an important role in the inception and progression of neurodegenerative diseases such as Parkinson's disease. In vivo imaging of Complex I offers a unique method for evaluation of these changes in living human brain. Previous carbon-11 labeled rotenoids showed promising results, but were prepared as mixtures of stereoisomers at the 5'-position. We report here the stereospecific syntheses of (-)-6',7'-[C-11]dihydroroten-12 alpha-ol ((-)-[C-11]DHROL), a modified rotenoid with in vitro affinity for Complex I. O-[C-11]methylation of the appropriate desmethyl precursor provided (-)-[C-11]DHROL in an average radiochemical yield, corrected to end of bombardment, of 27% (n = 4) and >99% radiochemical purity. In mice, (-)-[C-11]DHROL gave a high and uniform brain uptake similar to that obtained with prior radiolabeled rotenoids. Further in vivo evaluation of (-)-[C-11]DHROL in rats with unilateral quinolinic acid-induced striatal lesions showed significant losses of radioligand binding after neurotoxin treatment (lesion/unlesioned ratio of 0.66). As this reduction of in vivo radioligand binding is very similar to that obtained previously with the mixture of [C-11]DHROL isomers, the stereochemistry at the 5'-position of [C-11]DHROL does not significantly influence the in vivo applications of this radiotracer.