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I don't really play a lot of characters : 80% of my games are Akali's, 15% are Leblanc, and sometimes I play Poppy and Kayle. I think I can say "I know how to play Akali". ;p
RUNES
9 AD Mark + 1 AD Quint + 1 AD Glyph (10.13AD) is just enough to proc your Spell Vamp buff (no wasting of runes)
Then I go MRes glyph and Flat HP seal (or Armor seal). My gameplay early game requires me to absolutely not being too squishy (will explain later).
SKILLS
Captain Obvious is obvious. Prioritize Mark of the Assasin (q), get one point at lv2 for Twilight Shroud (w), and then go Crescent Slash (e). Level up Shadow Dance (r) whenever you can.
Nothing silly here.
MASTERIES
9 point in Offense to get Archaic Knowledge, then 21 in Defense (hp, mres, armor, +4%ap, ...). Akali was squishy, she's not that much anymore.
ITEMS
Start with Amplification Tome (+20AP) and 1 HP Potion : you will proc the AP bonus buff that way. Then, either choose Sorcerer's Shoes or Mercury's Tread depending on how many CC there are against you (I usually prioritize Sorcerer's Shoes, and I'm currently considering Moonflair Spellblade into my build). Rush Rylai (I can't imagine an Akali without the slowing effect early/mid game), then Lich Bane (double attack = omg burst), Hextech then Rabadon. Last item is situational, depending on who is against you.
EARLY-GAME
The most important time of the game.
I believe Akali to be near useless until level 6. So I decided to make her kind of useful.
I prefer not to play Solo Lane or Mid Lane, because there's always a character better than Akali for that job.
First priority : keep your health at max. This doesn't necessarily mean that you must play very very safely. Just know (learn) the characters you're playing against (their skills, their CD, their range) and act properly. If you're not solo lane or mid lane, know your partner's character and watch him closely.
So, how do I make useless Akali into useful Akali ? By braining my opponents.
You can't harass that much with Akali early-game, but you can scare them. Play with your shroud ! Your shroud should always be on the field because this is how you can scare your enemies, check brush, and most of all waste their mana (if they do have). Place your shroud near your opponents, place your shroud, enter it, and MOVE. Most of them will either flee or cast their spells, so you must dodge them. Don't do anything silly tho. Harrassing them with Q is okay, but your goal is not to reduce their hp, your partner will do it. If you're sure that you can harass them with an auto-attack without losing HP, then do it.