- Anti-Mage's burns Medusa's mana easily, especially when coupled with a .
- Can easily initiate on Medusa with , burning her mana or forcing her to use Stone Gaze.
- is effective against Medusa's big mana pool and mana usage, presenting a huge hazard to Medusa's allies around her since her Mana Shield still gives her some protection if she has mana.
- Unlike other illusion heroes, won't be instantly destroyed by Stone Gaze since it is considered a clone and not an illusion.
- He can use either his own or his double's to bypass the spellblock from Linken's Sphere, using the leftover Flux + to slow Medusa's move speed to a crawl.
- Arc Warden has a farming advantage with double , and can generally bully Medusa with other items that benefit from duplication.
- is a large mana burn nuke which can hit Medusa's Mana shield with enough damage to lose even more mana.
- disarms medusa's ability to deal pseudo-AOE damage during teamfights.
- allows the opposing team to repeatedly stun Medusa in short succession, preventing her from successfully casting her ultimate due to its long cast time.
- Heroes who don't build escape or spell immune items, such as Medusa, will be caught by easily.
- Meepo has enough time to Poof away to his clone if Medusa tries to Stone Gazing him.
- Alternativey, Medusa can counter Meepo's blink initiation with .
- Level 4 burns 38,5% of Medusa's mana every 4 seconds if Medusa only increases her mana pool with intelligence. Additionally, 60% of the damage gets mitigated by Mana Shield, burning even more mana.
- Due to the passive nature of and , it can possibly proc Nyx's if he's within range of Medusa's abilities and isn't invisible.
- Medusa lacks single target damage, making Nyx with extremely hard to deal with if Medusa is the team's main damage source.
- and reduces Medusa's mana.
- While Stone Gaze isn't interrupted by , it can prevent Medusa from positioning herself adequately, leaving her vulnerable to the opposing team.
- Phantom Lancer with will very quickly burn Medusa's mana, making Mana Shield significantly less effective.
- invulnerability can be used to dodge Medusa's petrification from Stone Gaze, as well as Mystic Snake. 's 1 second
- Phantom Lancer's illusions outnumber Medusa's targets from Split Shot, likely shielding your team in the process.
- Medusa is especially vulnerable to Essence Shift, as both strength and intelligence contribute to her effective HP, while agility contributes to her damage.
- when timed right can be used to dispel Stone Gaze right after it petrifies Slark, allowing him to keep attacking Medusa throughout the duration.
- Sniper can outrange both Medusa's arrows and Stone gaze, allowing him to focus her down during a teamfight.
- Heroes with mana burning abilities will make Medusa much less tanky: , , .
- Heroes that build will also make Medusa much less tanky: , , , , .
- burns away the mana Medusa needs for Mana Shield.
- provides mana burning summons, and Split Shot makes Medusa especially vulnerable to getting hit with Last Will.
- disarms Medusa for a long 5 seconds.
- Enchantress often has a small army of neutral creeps, allowing Medusa to hit her with a later bounce of her Mystic Snake.
- Untouchable is ignored by secondary attacks from Split Shot.
- Lifestealer's low mobility makes him easy to kite.
- Stone Gaze pierces , wasting its cooldown and making Lifestealer unable to fight.
- Mana Shield blocks all damage before reductions, negating the Ethereal Blade + Adaptive Strike burst combo.
- Mana Shield tanks most of the damage from Reaper's Scythe; with sufficient mana, the kill threshold drops to 15%/17%/19% health (before reductions).
- Heartstopper Aura does not chip away at Medusa's mana.
- Necrophos has a movement speed equal to Medusa, and is easy to chase down with a slowing item in Medusa's inventory.
- Stone Gaze allows Medusa to easily kite and kill Sven.
- Mystic Snake eats away at Sven's small mana pool.
- Mana Shield negates much of Sven's burst damage.
- Split Shot can destroy Tombstone Zombies and Tombstone itself while still damaging heroes.
- Mana Shield reduces the impact of Decay and Flesh Golem's Plague Aura.
- Mana Shield is applied before armor reductions, drastically reducing the effectiveness of Corrosive Haze.
- Mana Shield can makes Medusa harder to kill with Enigma's Black Hole
- Medusa's Split Shot can kill Demonic Conversion creeps easier.
- Stone Gaze makes it hard for Enigma to approach Medusa for a Black Hole.
- Mystic Snake can harass Axe in lane and drain his small mana pool.
- Mana Shield reduces the effectiveness of Counter Helix.
- Split Shot and Mystic Snake can remove Battle Hunger by hitting creeps.
- Stone Gaze makes it very difficult for Axe to pursue.
- Stone Gaze negates Dispersion's damage reduction and allows Medusa to kite Spectre.
- Spectre's small mana pool is depleted quickly by Mystic Snake.
- Split Shot can clear Haunt illusions quickly.
- Heroes that rely on summons. A few summons, such Lycan wolves allow Medusa to bounce her Mystic Snake between them to hit the hero for additional damage. Many weak summons, such as Broodmother force the group to tank Medusa's split shot.
- Heroes that rely on Black King Bar to survive teamfights.
- In theory Medusa counters all melee heroes, even though that is not the case with Mana-burning heroes and heroes with escapes, Medusa can outfight even Anti-Mage if he gets petrified.
Works well with...
- Deals area damage with ultimate and can stun/disable to cast Stone Gaze and make it easier to freeze enemy heroes.
- Berserker's Call can force enemies to face Medusa during her Stone Gaze.
- helps Medusa fires more Split Shot.
- Drow Ranger's midgame strength allows Medusa to farm safely, then take the lead once Drow Ranger's relative strength drops in the late game.
- benefits Medusa's Mana Shield greatly, and also allows more liberal use of Mystic Snake.
- Stone Gaze slows enemies and stuns them for a duration. With correct timing, Keeper of the Light can land a fully-charged on multiple enemies.
- helps ensure enemies face Medusa when she casts Stone Gaze. Both ultimate abilities have a long duration, causing massive disruption in teamfights.
- During teamfights, casting Disruption upon Medusa creates a pair of illusions with Split Shot and 80% of her base damage.
- Shadow Demon can stack 2-3 jungle camps at the same time, speeding up Medusa's farming phase.
- Stoned enemies are immune to magical damage, but Shadow Poison can still build stacks during the Stoned phase.
- Witch Doctor's ultimate deals physical damage, so if Medusa managed to petrify a bunch of enemies with the given physical damage bonus, can shred through enemies especially with Aghanim's Scepter
- Heroes that deal pure damage like Tinker's Aghanim Laser upgrade can give him enough time to cast it a couple of times or Outworld Devourer can deal the full damage of his Arcane Orb and stack a lot of intelligence for those 3 seconds of Stone Gaze
- Everyone with good physical damage and lock down for a good Stone Gaze
- Abilities that grant sustain or heroes with sustain to keep the enemy kited and distracted while Medusa slowly destroys them
- , , and restores both health and mana to Medusa, doubly effective as a sustain item since she can tank with Mana Shield.