Pre-6, you only want to gank if either 1) an enemy laner is overextended into one of your lanes that has CC, or 2) you’re ganking a lane with no summoners. Pop ghost, run in, and get a free kill. Otherwish, PERMAFARM until six. Your camp clear is insanely efficient, especially against krugs, raptors, and wolves. After first clear, you should back, buy boots and a pickaxe/tiamat, and head back to krugs (if you started red side) or gromp (if you started blue side) and full clear again. Once you hit 6 and get blue smite, you should have around 400 bonus health from your W passive, and you’ll likely be 2 levels up on the enemy jungler if they forced ganks (something aggressive junglers like Graves, Elise, Lee Sin, and Zac will often do). If the matchup is favorable or even, try playing around your topside for first Rift Herald; if they got counterpicked, play around bot for dragons instead.

The late game plays out relatively normally for a tank, although you have enough AD after Titanic that you can likely go for picks and seek out fights against most squishier enemies. The most important things to remember are to play like a support, using your Q and R to set up or turn around teamfights with area knockups, while still dealing the damage of a carry and having the beefiness of a tank. Additionally, you need to ALWAYS keep up the tempo of your farming. Sion’s W passive gives him 4 HP for killing a small minion or monster, and 15 for a large minion or monster: that’s ~7 gold or 25 gold’s worth of free stats respectively. Most junglers get 85 gold from clearing raptors; you get 85 gold and 35 health, or another 95 gold’s worth of stats for a total gold value of 180. Wolves and gromp are only a little less efficient, while krugs are even more efficient, since the camp consists of 1 large monster and 9 small monsters for a total of 51 bonus health every time you clear the camp. Full clearing your jungle, excluding buff camps, gives you 124 bonus health every time. That’s equivalent to 2.5 AD on your titanic hydra, or 20 extra healing from Death’s Dance every time you get a takedown.

All effects on a champion end immediately when they die. This means that you can’t use Ghost or activated items before you die and keep their bonus when you’re in your passive. Additionally, you can’t use summoners spell when you’re in your passive, but you CAN use items. Ghost should only be used at the start of a fight to engage, while Youmuu’s, Predator Boots, and Chemtank should be saved for when you die.

The health decay inflicted by Sion’s passive is health drain rather than any kind of damage, meaning it isn’t mitigated by shields. As such, Gargoyle Stoneplate doesn’t do much for you when you’re in your passive.

At a pitiful 73, Sion has the lowest base health growth after Kled and Gnar, both of whom have forms that significantly amplify their HP. Most of his health comes from BONUS HP from items, and more importantly, his W passive. This is why items that scale with bonus HP (titanic hydra, gargoyle stoneplate) are better on him than almost any other champion in the game!

Titanic Hydra giving 1 AD per 50 health might not seem like a lot, but worth noting is that it also grants an additional 1.5% maximum health physical damage on-hit. With 0 stacks and no other items, Sion gains 10 AD and 40 extra physical damage on-hit at level 18. With 1000, he gains 30 AD and 55 on-hit damage, multiplied to 110 against enemies caught in titanic’s cleave passive.