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I noticed there was an alarming lack of Nasus builds here and I've seen some really bad ones, so I am going to just make a quick (and pretty incomplete) build so that people have some idea of how to play him.
Ok, first off, Nasus will not be supreme until late game. Yes, you can do stuff before then but you'll need an advantage, whether that's health or numbers doesn't matter.
That being said, here is what most of being a good Nasus player consists of:
Use Siphoning Strike everytime its off cool down to last hit a mob. It doesn't matter what mob it is, just kill it. SS gains 2 damage every kill you get with it. This may seem insignificant now, but it will really add up. On an average game, I will end up with about 200 bonus damage on my SS.
So, what else is there to playing Nasus? Well, he gets a really good slow. I generally try to take just one rank of that at level 2 so that I have a good slow for all of early and mid game. Then I focus on his other three skills. Obvious the ultimate gets priority if you are the right level, but otherwise always take a rank up of SS over his targetted AoE. The higher up SS is, the more base damage it does. This makes it even easier to rack up the kills with it.
A note about his ultimate: It rocks. Seriously. the cooldown isn't too terrible on it and it does good AoE per second damage to everyone around you based off of their max health. Great for taking out tanks, but still pretty good for anything else. Save this for team fights to give your team an advantage or use it if you need to scare someone off. Chances are if they know who Nasus is, they will back off when you pop your ultimate.
So, what about items? Well, you can tailor it to whatever it is you need in each game. Nasus gets a baseline 20% lifesteal which is generally good enough for the entire game. I like to get some semi-defensive items like Phantom Dancer for the dodge rate. Either way, Madred's Razors seem like they might be a good choice, but watch out. That proc will generally steal your SS killing blow. So while it can be good for taking out the buff mobs earlier than normal, I'd say stay away from that. Other than that, get some magic resist if they have some nukes or get some armor and HP if they have the typical carry heroes. Fortunately, the 20% base lifesteal makes items very lenient on Nasus, as long as you get at least some attack speed.
As far as runes go, well I'd say rune for one of two things: either attack speed/damage for an offensive build or HP for a more well rounded build.
And summoner spells, well that depends on your team composition. Since he already has a slow, exhaust is good but not mandatory. Teleport can be nice so that you can recall to base, refill your mana and then teleport back without missing much. You'll never want to be in your lane without mana, because that means you aren't using SS to kill mobs. Heal can really up his survivability with his beastly ultimate and lifesteal.
Really, just don't pick obvious poor choices (like ignite or smite) and you wont have trouble.