Glycobiology, broadly defined as the study of sugars in living systems, is becoming increasingly important for understanding the basic biology of the central nervous system (CNS) and diagnosing and devising new treatments for neurological disorders. Decades of research have uncovered many roles for both glycolipids and glycoproteins in the proper functioning of the brain; moreover many diseases are characterized by abnormalities in either the biosynthesis or catabolism of these cellular components. In many cases, however, only a rudimentary understanding of the basic biological roles of sugars in neural function exists. Similarly, methods to detect and diagnose glycosylation disorders are far from state-of-the-art compared to many facets of modern medicine. This review focuses on sialic acid, arguably the most important monosaccharide in CNS, and describes how recent advances in its manipulation by chemical and metabolic methods hold the possibility to converge with advanced instrumentation such as magnetic resonance imaging, positron emission tomography, diffusion tensor imaging, and single photon emission computerized tomography now used for imaging of the CNS in human subjects. Specifically, methods are under development for tagging sialic acids in living systems with contrast agents suitable for magnetic resonance imaging, in essence allowing for the functional imaging of sugars at a molecular level. One of these methods, biochemical engineering of sialic acids by use of small molecule metabolic substrates, also holds promise for the manipulation of sialic acids for the development of novel therapies for neurological disorders.