This is my first build so comments and feedback are welcome and appreciated.

This Twitch build focuses on "on-hit" effects.

While playing him, preferably lane with another champion at top or bottom lane.

Boots of mobility are good for ganking people, and traveling between lanes quickly after going mia.

When engaging in a fight 1v1- You should auto attack for the stacks of poison and expunge when their HP is below 50%. The on-hit effects should tear up their health quickly.

When engaging in anything other than a 1v1 let a teammate initiate the battle, because you don't have any lifesteal on this build.

If you absolutely must engage a 1v2 or god so help me a 1v3 use the ability on your sword of the divine and drop Spray and Pray. All of your attacks will hit, no matter who you're facing. Pop expunge when their hp is low, and stealth away if you can't handle it.

With the rage blade your AS will quickly become maxed out, and your ultimate will push through your targets and do insane damage to any enemies dumb enough to stand in a line. The Rageblade also assists with your expunge giving you that extra damage after cutting through enemies with your auto attack.

Twitch is always better in the back of the team fights, using his tanks as cover, Twitch can easily obtain a god-mode and never die.

Remember that items always depend on who you are facing. If there aren't any HP tanks on the other team you may want to get a Bloodthirster, or a Last Whisperer, for that extra damage and armor pen.

This twitch build needs a tank or a stun to work at it's full extent, twitch is a very squishy character and if stunned or thrown he could easily die.

Runes don't really matter here, you can play this twitch many ways, DO NOT play with AS runes, your AS will be maxed out with this build. If anything play with Armor pen runes, they will come in handy while facing enemies like Rammus or a tanky Udyr.

Credit for build goes to iFSU Spyder