Note that this is a post-nerf guide for Twitch. He was more viable when he still had his beefed up ultimate, but he is still a very viable champion if he is played correctly. Most people see a Twitch and say "Oh, someone is trolling the team again." After they play a game with a Twitch that knows what he's doing, they'll change their minds.

Now, there has been quite a bit of study on the rune combination for Twitch and end game vs early game setups. Due to the armor pen nerf, I swapped out all of my runes for flat Crit Chance. You might be thinking that I'm a noob for this choice, but let me explain my decision.

My mastery setup is meant for early ganks and damage buffs. I take the extra points in defense because Twitch is squishy as hell to begin with. I fill out the extra points in the AD tree, and then proceed on.

Some people may have a personal preference for a build on Twitch, but after playing well over 500 games with him, I've found one that works quite well.

Start the game with a Doran's Blade. This gives you the extra HP and Lifesteal for sustain, as well as allows you to last hit more effectively. This is a personal preference as I said before, but I've found that stacking 3 Doran's Blades on Twitch allows for a fairly beefy ranged AD. As the game reaches end-game state, the extra blades are sold for more pricey items.

My skill sequence for Twitch is to grab Stealth at level one, and max your E as soon as possible. The extra attack speed and duration on stealth is good, but the unexpected damage from expunge allows you to get kills much easier. Max your expunge first, followed by your Stealth and max your slow last. I grab my ultimate as soon as possible.

Ignite and flash are a great combination on Twitch. Ignite allows for stacking of DoT's, and flash allows you to get out of sticky situations while your stealth is activating.

Exhaust and Cleanse are also viable if you don't wish to use ignite, as they both allow you to live longer to do more damage.

Never get heal/tele/surge on Twitch. Wasted space.

With the attack damage masteries selected and having a full page of T3 crit chance runes, you start the game at level one with 24% critical strike chance per hit. You may think that's not a lot, but Twitch's built in AS makes this a life saver. Whether you're mid, duo bot, or even jungler twitch, level one (two if jungling) ganks are always needed.

With the 24% crit chance setup, I always go mid as twitch for my gank, then go to my respective lane. Wait until the enemy champion returns from leashing blue buff, and have your teammate bait them into attacking them. Even a slight movement to your side of the lane could cause the death of them. Activate your stealth, wait for it to cloak you entirely, then go behind the enemy champion. Whether it be top, bot, or mid, you must always position yourself correctly. Being behind the enemy champ allows for your teammate to attack from the front while you constantly barrage them from behind. This will cause them to blow their flash at level one, or will result in you getting first blood. With Twitch's DoT passive and an ignite, it's fairly easy to kill them even after flashing. Tower diving at level one may be frowned upon, but if you can get first blood you get the extra gold, as well as the assist for your teammate. This makes the enemy lane much weaker, and allows for a better late game.