The goal was to automate and optimize the shaping and positioning of a shape-specific/conformal voxel that conforms to any volume of interest, such as a cranial lesion, to allow conformal voxel magnetic resonance spectroscopy (CV-MRS). We achieved this by using a computer program that optimizes the shape, size, and location of a convex polyhedron within the volume of interest. The sides of the convex polyhedron are used to automatically prescribe the size and location of selective excitation voxels and/or spatial saturation slices. For a spherically-shaped, phantom-simulated lesion, CV-MRS increased the signal from the lesion by a factor of 2.5 compared to a voxel completely inside the lesion. CV-MRS reduces the voxel prescription time, operator subjectivity, and acquisition time.