Functional magnetic resonance imaging (fMRI) studies have demonstrated music-induced activation of the blood-oxygen-level-dependent (BOLD) signal across brain networks associated with auditory perception, motor control, and emotion. However, BOLD-fMRI reflects vascular responses that may not fully capture underlying neural activity. Here, we used simultaneous [¹⁸F]fluorodeoxyglucose (FDG) functional positron emission tomography (fPET) and fMRI to examine glucose metabolism closely linked to neural activity, alongside hemodynamic responses during pleasurable music listening. Thirty-five female participants listened to self-selected pleasurable music and control stimuli while undergoing 90-minute PET-MRI scans. In fPET, the music > control contrast revealed music-evoked increase in glucose consumption in auditory and motor cortices, as well as reward-related regions, including the nucleus accumbens (NAc), caudate, insula, and orbitofrontal cortex. The fPET and fMRI results showed substantial overlap though some discrepancies were also observed. Notably, the NAc exhibited increased glucose consumption in fPET but showed no activation in fMRI. Conversely, deactivation of the default mode network during music processing was only observed with fMRI. These results highlight the complementary nature of neurometabolic and neurovascular processes and offer novel insights into their dynamics during the processing of aesthetic rewards.