Thresh Top Lane is ranked Off Meta Tier and has a 33.22% win rate in LoL Patch 13.23. We've analyzed 5211 Thresh Top Lane games to compile our statistical Thresh Build Guide. For items, our build recommends: Plated Steelcaps, Heartsteel, Statikk Shiv, Sunfire Aegis, Titanic Hydra, and Thornmail. For runes, the strongest choice is Precision (Primary) with Press the Attack (Keystone), and Resolve (Secondary). The optimal Summoner Spells for this build are Flash and Teleport. Starting items should include Doran's Shield, Health Potion, and Stealth Ward. Thresh's Best Top Lane matchups include Skarner, Udyr, and Akali. Thresh's Best Top Lane counters are Yasuo, Naafiri, and Tryndamere.