Karthus Top Lane is ranked Off Meta Tier and has a 50.83% win rate in LoL Ultimate Spellbook Patch 11.24. We've analyzed 1108 Karthus Top Lane games to compile our statistical Karthus Spellbook Build Guide. For items, our build recommends: Liandry's Anguish, Sorcerer's Shoes, Archangel's Staff, Demonic Embrace, Shadowflame, and Rabadon's Deathcap. For runes, the strongest choice is Domination (Primary) with Dark Harvest (Keystone), and Precision (Secondary). The optimal Summoner Spells for this build are Placeholder and Flash. Starting items should include Amplifying Tome, Tear of the Goddess, Health Potion, and Stealth Ward. Karthus's Best Spellbook Top Lane matchups include Kennen, Vayne, and Camille. Karthus's Best Spellbook Top Lane counters are Jayce, Irelia, and Pantheon.