Medusa AAC Patch 10.13

Agreed. Really wouldn't want to go with this build as-is.

So right now, you have Manikin, Devo, Dom, Rage, Griffon, Fail. Comments on those choices and recommended replacements.

• Manikin Scepter is just not the best starter for anyone but a jungler in Conquest usually, and one that gets the jump on an enemy. Manikin Hidden Blade is a nice upgrade, but again, only for specific gods. That's usually not Medusa, though she can be fun as an alt jungler. As a basic attack focused ADC, get a standard ADC starter. More on that later.
  
  
• Devourer's Gauntlet is fine, but depending on the other items you get, I would also consider Asi. I typically like 4 items with some amount of AS for Medusa. If you're getting Deathbringer and Fail-Not, I'd go Asi.
  
  
• Dom is good. I like the MP5 for Medusa.
  
  That said, I'd also consider The Executioner. Depending on if you really *need* anti-heal, or you want more CDR, I'd consider Exe for The Ferocious Executioner glyph, which is great for extra damage. You currently don't have any items that you can upgrade w/ a glyph, so that's something you should consider. Also, with her having good ability use, getting some Exe stacks and following up with Viper Shot or Lacerate is useful.
  
  
• Rage is nice, and if you're only getting 2 crit items, it's a good one to get. But in this case, I'd opt for other items. This is just high crit chance, other items will bring better utility.
  
  Demon Blade is better suited here. The extra % pen is nice (perfect in combo with Dom) and the AS is good, again better when you have 2 items without AS.
  
  
• Griffonwing Earrings is nice for any hunter, but it's really an early item due to the basic stats and price. It's not an item Medusa needs, and in this case is just not preferred. At the point at which you buy this item in your current build, you'd just be better served with other items...Exe or something else.
  
  
• Fail-Not is a solid item for her. CDR is great. Paired with Malicious Deathbringer it's really nice.
  
  
• Alt starters: Leather Cowl: if you're going 3 crit items, I like this starter. As long as you're around your teammates, the AS is nice and late-game, the AS aura from Hunter's Cowl is great if you have other basic attackers on your team, and especially for objective takedown. Leader's Cowl can also be really good, and I think its passive combines very well with Ferocious Exe.
  
  Gilded Arrow -> Ornate Arrow: if you only want 2 crit items, AND you're okay waiting for late-game, this is a solid direction. If either of those 2 don't work for you, I'd choose a different starter.
  
  Death's Toll -> Death's Temper: It's ok I think, but I'd usually default to Cowl at this point. The way Temper's passive stacks is a bit awkward at the beginning of a teamfight.
  
  
• With 4 AS items, yes, you will likely overcap AS when Viper Shot is active. No, it usually isn't worthwhile to build Silverbranch Bow...but having higher base AS is just generally nice for her overall DPS, esp when Viper is on CD.

So yeah, if you go Cowl -> Asi -> Dom/Exe -> Demon -> Deathbringer -> Fail-Not, it's a solid build with good % pen, 20% CDR, and 2 item options to upgrade glyphs depending on need.

If you would prefer Ornate, I'd probably commit fully to basic attacks, drop Fail, and pick up Exe late (or get Exe early and Dom late, either way).

I'd definitely go that either of those directions over the current build.