Hello there! This is my Twitch build. I have been playing Twitch for quite a long time, and I have to say that this champion is one of my favorite. This build is in my opinion the best build there is for twitch, the damage output is MASSIVE and besides the massive damage you can get a lot of lifesteal because of the bloodthirsters.I haven't played a lot of ranked games with twitch, but every game that I did play ranked with Twitch I won.
So, lets enjoy the guide!

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Pros +Using Ambush allows you to scout bushes +[Debilitating Poison] Is a very good slow once you have some stack ons your target +The range of expunge is good enough to finish off enemies when they walk to a turret. + Spray and Pray passes trough enemies, If you have Bloodthirster you will return a lot of HP.

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Cons -Like any other carry Twitch is squishy -Mastering Twitch can take a decent amount of time -Only two buyable skins

A big thanks to jhoihoi!

GREATER MARK OF DESOLATIONGreater Mark of Desolation In my opinion, you will really need this, there are a lot of people, that play off tank or maybe even full tank, so if you have armor penetration, you will do more damage, and that is what we want right?

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Greater Seal of Alacrity This build is for the attack speed, with the attack speed you will be doing damage insanely fast! with this build, you will have the maximum attack speed (2.500) but ofcourse to reach this you need some attack speed, this explains these runes ;)

Glyph of Alacrity Well, this is even more attack speed, if you still dont get it, we're going for 2.500 attack speed and when we reach it we will do a HUGE amount of damage.

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Greater Quintessence of Might In my opinion, these runes are the best, they will not be as good as [greater quintessence of strenght] early game,but you will get more attack damage late game, and I think that this is more important.

In my opinion, you should stick to these runes, you can change your Greater Quintessence of Scaling Attack Damage to a greater quintessence of strenght but that is your choice.

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Exhaust is a very good spell, it is usefull when you are going to 1v1 someone as I always outdamage the enemy, I also like this skill for if the enemy is going to run :)

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Flash is in my opinion always a good summoner spell, it is always there when you need it, and you can use it for running and chasing!

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Ignite is a very good summoner spell, in combination with Deadly Venom will bring a good dot on a target, and will make it even more likely to bring him down.

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Ghost is a good spell, if you seem to be ganked a lot, and you are not able to escape. You can choose this over Flash but i think Flash has some more uses.

Heal is a ok summoner spell, I do not like it myself as I find it bad late-game, but if you are dying too often you can give it a shot (maybe you could add some poison!).

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You should not die.

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Ghost is better.

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You are not a support.

Not available on 5v5 or 3v3.

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You don't need a big minion.

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we already have the attack speed cap, and ability power is not very good with Twitch.

I think that this is the best starting item, i have tried Boots before, but i really miss out on the small amount of damage, 100 hp and the 3% lifesteal. Yes, the 3% lifesteal is usefull, together with Vampirism this will add up to 7% lifesteal, wich is enough sustain for the moment.

Yes, I love these, the 25% attack speed is a good start for the beginning, and they also give a little speed. Talking about boots, I heard a lot of people saying that Mobility Boots are better, but in my opinion, it depends on the game mode you play in 3v3 Berserker's Greaves are better, but in 5v5 Mobility Boots becomes a competitor so if your team is in need ganks, buy Mobility Boots if not go for the Berserker's Greaves

This is a great item, as it gives a lot of damage, and also some "Armor penetration" you can say. The 3 stacks will be reached in No-Time. For some reason I tend to get this very early into the game with my friend playing a support like Taric.
i suggest getting a vamp scepter rather early, as you are going to need a bit of lifesteal, but you don't need Bloodthirster yet. Spray and Pray + Vampiric Scepter = WIN .
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This is just the build for a Phantom Dancer This is good build, some attack speed and a little bit of crit chance.
This is a good item, nice attack speed and the crit chance will build up, and be a nice 55% ojnce you also have the infinty edge and ofcourse look at the passive 250% damage! This is a pretty hard item to get, and you are going to need some kills for that, but ofcourse you will manage with this good champ.

This is some nice attack damage, but ofcourse we're going to use it for Infinity Edge so not a lot of information for this item right now.

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This is a very important item for Twitch, if you have Infinity Edge in combination with Phantom Dancer you will 55% crit chance wich is a descent amount. Ofcourse we want the passive of this blade for a reason, so you wwill have a 55% crit chance with a 2.500 attack speed, and a nice amount of damage. Conlcusion: "Crits will do a Phreak load of damage!"
This is a great item, it basically destroys champions who stack health such as Dr. Mundo also some nice damage on this item.

This is a good item, but I choose it last for twitch, because I think you need the other items more then this one. Having Bloodthirster wil give you a nice amount of attack damage, especcialy if you have the passive. By having one Bloodthirster your damage will even more increase, and your lifesteal will be unbelievebly high. Keep in mind that Spray and Pray passes trough enemies, and so damages everything that Twich hits and then steals their life. If you have this build completely build out, you are almost not invinceble!

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Deadly Venom This is Twitch's passive. It adds a DoT (Damage over Time) to the target(s) You are hitting, this passive is used in combination with Venom Cask and expunge. This ability does 2.5/5/7.5/10 true damage per second per stack. With six stacks your damage is 6x10=60 True damage, this happens for 6 seconds, so 6x60=360. With max stacks and with a 6 seconds duration of the venom, you deal 360 true damage. This is a great lucker finisher, and sometimes even kills someone that you didn't damage anymore because you had to back out of fight because you were almost dead.

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Ambush (Q) This is Twitch's Q, it allows him to go stealth, this is the most important skill on Twitch. This ability can be use for several things, such as sneaking up on enemies, also gives a speed boost, wich is really helpfull.

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• Use this ability to scout bushes, and help your team!
• Use this ability to get behind your enemy, and get the suprise of attack, a natural reaction is to run, wich is with Twitch not a smart option.
• It takes some time to get into stealth, so wait untill you are stealth untill you are going to stand behind your target!
• If you use Ambush in a bush, they won't even know that you left the bush, and you can use this to get an ever bigger suprise
• Even if someone has an Oracle's Elixer still use Ambush for the attack speed buff.

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Debilitating poison (w) This is Twitch's w (WOW SERIOUSLY??). Not a lot to say about this, it can be multi target, but is not always. Also, if you seem to not need the slow while laning, don't take it. (I'd say that you MUST have it by level 8, this is ussually the level I pick it up in 3v3.)

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• Don't use this ability right away, unless someone is running that you have not attacked yet.
• if you use Spray and Pray and hit enemies, this slow will be multi-target.
• This ability does NOT remove stacks of Deadly Venom .

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Expunge (e) This is your main damage source for early, and mid game. The damage on this skill increases the more stacks of Deadly Venom you have on the target. At level 5 one single stack will do the base damage + 60. The maximum amount of stacks is 6, so 60x6=360 damage from the stacks. This amount and the base damage add up is: 360+150=510. A lot of damage for a skill that you will have maxed at level 9.

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• Wait with using this ability untill you have some stacks of Deadly Venom on your target.
• Use this skill to just kill someone under the turret (if they still have some stacks on them)
• Sometimes it is usefull to wait with using this ability, E.G you are in a 1v1 fight against let's say Urgot (no reason, just my friend saying I should go against him) and the fight is even, so he won't run BUT THEN! you pop expunge, and BAM you're winning the fight, and he wasn't running up till now, so more time and chance to kill him!
  

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Spray and Pray (r) This is Twitch's Ultimate. It makes your basic attacks pass trough enemies, and you gain attack damage. When this skill is active you do massive damage to multiple targets at once.

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• Use this ability in every teamfight, 1v1 basically any fight you can.
• Multiple target slow
• Multiple target damage with expunge

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A great item for some more defence, also some health and an ability blocking shield.
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Just like Black Cleaver a good item against armor stacking tanks, some additional damage and some nice armor penetration. In combination with your runes you should be able to pull of a lot more damage to the tanks.
When to buy Last Whisper instead of Black Cleaver? Well according to "Fuggernought" :
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"WUTT?" You may ask. "Cleaver shreds more?" Yes it does. So, when you have to chose between buying Black Cleaver and Last Whisper, you first need to know the "Sweet Spot" of Last Whisper, when it will penetrate more than Cleaver can shred.

45 Armor Shred of Black Cleaver / 40% Armor Pen of Last whisper = 112,5 Armor

The "Sweet Spot", the exact number of Armor the target must have in order for Last Whisper to be more effective than Black Cleaver is 112,5 Armor. When the Target has 112.5 Armor or more, it is more beneficial to buy Last Whisper in terms of Armor Pen. Source
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Some magic resist, and a debuff removing item, this is a nice item for a champion such as Kennen
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A good item against AP carry's, also some extra damage is ofcourse always nice :D
Ionoic spark I like this item for 3v3, wouldn't reccommend it for 5v5 tough.

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Oracle's Elixir This item will probarbly be picked up by a support like Sona or Taric or basically any support. I think this item is worse than placing some good Vision Ward's. If a support pickes this up, it will be mid to late game most of the time they don't pick it up early game. If a support buys this item, I reccomend going into a bush and killing him ASAP, as this item can mean your death. Also if you kill a support that just bought this item he/she just wasted 400 gold!

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Vision ward This is an annoying item, as you may not even notice that this ward has been placed. This is why I ask my support to get an oracle pretty early into the game. If the enemy buys a vision ward it is most likely that they place it in the middle of the lane, or the brush closest to your base, because that is where you ussually use Ambush So if an enemy buys a Vision Ward ask your support if he/she can buy an Oracle's Elixir .

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Pros + Great ganks while in Ambush! + Good jungle invasions.

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Cons - Squishy - need good positioning with Spray and Pray

If you want to try Jungle twitch, I reccomend reading This Guide

All in all, Twitch is a very good carry when he is played in the correct way!
I hope you enjoyed reading this guide. This is my first guide ever and I hope it's a reasonable guide!
Please comment on this guide if you have a question, suggestion or maybe even when you found a mistake.

I want to give a huge thanks to Jhoihoi for her guide on making a guide and for inspiring me!

-Fionn

Changes etc:
27/03/2012 Published the guide!
10/05/2012 Added section "Good laning partners"