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Aegis Amulet or 
Purification Beads depending on what you need.
Take Aegis Amulet or Purification Beads depending on what you need.
Death's Toll
Spiked Gauntlet
Healing Potion
Multi Potion
Aegis Amulet
Purification Beads
Viper Shot which has 60% attack speed for 4 auto attacks your first 4 basic attacks will deal tons of dmg + if you crit you can delete people. Also with this build you have huge anti heal of 90%.
With her first ability the Viper Shot which has 60% attack speed for 4 auto attacks your first 4 basic attacks will deal tons of dmg + if you crit you can delete people. Also with this build you have huge anti heal of 90%.
Death's Temper
Devourer's Gauntlet
Shadowsteel Shuriken
Fail-Not
Odysseus' Bow
Silverbranch Bow
Temporal Beads
Fortifying Shell
These are all the relics u will ever use
Aegis of Acceleration
Phantom Shell
Fortifying Shell
Temporal Beads
Take anything what you prefer really.
Qin's Sais
The Executioner
The Ferocious Executioner
Demon Blade
Envenomed Deathbringer
Dominance
High pen Build for tank shred.
Death's Temper
Devourer's Gauntlet
Shadowsteel Shuriken
Fail-Not
The Ferocious Executioner
Silverbranch Bow
Aegis of Acceleration
Temporal Beads
Hello guys I am Rob a big Smite fan presenting you some of my build ideas and it would be really nice from you to leave me any kind of feedback. Tell me what you like or dislike about my builds I will gladly respond to all asked questions. And if you like my guide leave Thumbs up or thumbs down in case you dislike my builds.
I am posting builds only tho so for gameplay info feel free to ask me anything in the Comments.
I am here to not only hopefuly help some people with builds but also to learn myself.
Thank you <3
!!! All of my builds were updated to the last patch version of the game so all my builds are now up to date!!!
Medusa is one of my most played gods, she is deadly as an assassin and can also clear the lane with 
Acid Spray ability, as an adc she can keep up with any other hunter. I prefer to play her more aggressively as she has antiheal in her ability + good attack speed for 4 attacks and her ult is 1 of the strongest ones in my opinion.
Pros:
Oneshot potential.
Good minion clear.
Antiheal in her kit.
Good cc and also cc imunity while using ult.
Her passive makes you harder to get hit as you move without any penalty to the side and only 50% penalty while going back.
Cons:
After your dash
Lacerate is used to catch someone you are a good target to be focused down.
Your dash ability can not go through the targets so if there is any god in your way you stop at his position.
Her first ability Viper Shot is her main dmg ability to kill other gods. This ability gives u attack speed, strong dot dmg and can crit. So if you crit while your Viper Shot is activated. Max this ability after u max Acid Spray.
Her second ability is Acid Spray, this ability is her lane clear so always max it up.
It splashes further away if there are any targets in the range of the first target that was hit.
Her third ability is Lacerate, dash with antiheal, root and good dmg. Does not dmg lane minions or camp monsters. The dash has pretty long range but if you hit any enemy god while using the dash you instantly stop and hit the god. Also it is only single target ability so it can root only 1 enemy.
Her Ultimate Ability is 
Petrify, big cone, dmg and cc ability. It has rly good range but many players can easily dodge it or turn their back to you so they negate the stun. Try to use this ability while being in the backline behind your tanks so they block the view of your enemies. After you hit anyone who is facing you they get stunned for 2 seconds and are slowed. Best combo to use with this ability is to use:
Petrify-> Acid Spray-> and auto attack with Viper Shot
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But if you're playing Mid, or doing an ability build in a non-Conquest mode, I do think
IF I were to go with a full ability build, I'd probably build as follows:
Transcendence
Ninja Tabi (or 
Warrior Tabi)
Soul Eater
Fail-Not or 
Jotunn's Wrath or 
Hydra's Lament
The Crusher or 
Brawler's Beat Stick
Titan's Bane
Heartseeker
Switch HS and TB as preferred. Can opt to skip Crusher/BBS. Can delay SE until later in the build, similarly to when you might buildEven if it's a sustain option I feel it's on the weaker end for most ability adcs. Reasons for this are that apart from the ability healing, the cdr and pen can easily be capped by the other items we see ability-based adcs picking up.
As they will always utilize
it also messes up your damage curve if you grab it early (3rd) (as getting flat pen is still better at this point or you want a high power item to keep high pressure).
if grabbing it I would suggest using it later (in the case of your example swapping it with BBS/crusher) this will allow you to keep your burst up during the early stages of the game. Or get no lifesteal/sustain at all but use a defensive.
BF would help burst a bit more, but on ability damage, you're not really talking a huge difference in damage numbers to be honest. 40 base damage difference (before mitigations) at max rank for her highest scaling ability (her ult). And SE will provide better sustain, CDR for an ability build, and % pen for late-game (and objectives). So I don't think you need to be "sold" on it, but it can still provide very functional stats.
Of course, this is just one option, and the location when you build it is also flexible (hence why I stated you can delay to later in the build).
I'd also say ditch the crit items completely, the cd you get from malice isn't worth it. Go with something like fail not if you want cooldown