* Sonic Wave is a bad choice in abilities if he and the Tempest Double both use Blade Mail to reflect the damage to Queen of Pain, potentially killing her outright if her health is low enough.
* Magnetic Field protects himself or his ally from Queen of Pain's attacks unless she has Monkey King Bar.
* One more advantage of Tempest Double is that he can deny himself if he is close to death with Shadow Strike's debuff.

* He can use either his own or his double's Flux to bypass the spellblock from Linken's Sphere, using the leftover Flux + Spark Wraith to slow Medusa's already low move speed to a crawl.
* Arc Warden has a farming advantage with double Hand of Midas, and can generally bully Medusa with other items that benefit from duplication.

* Because Queen of Pain's spells cost a decent amount of mana, Anti-Mage can easily use Mana Void if she spams her spells recklessly.
* Anti-Mage has similar mobility through Blink, which can allow him to catch up with her.
* Counterspell will reduce the damage done by Shadow Strike and Scream of Pain. Additionaly, Counterspell also reflect to Shadow Strike will return to herself.

* Anti-Mage easily destroys Mana Shield with Mana Break, especially once he has Manta Style.
* Anti-Mage effectively avoids Stone Gaze with Blink, and can reinitiate after its duration is over.
Additional:
* Mana Break burns Medusa's mana easily, especially when coupled with a Manta Style.
* Can easily initiate on Medusa with Blink, burning her mana or forcing her to use Stone Gaze.
* Mana Void 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.

* Smoke Cloud prevents Queen of Pain from using any of her offensive and defensive spells, rendering her unable to effectively react to Riki's attack.
* It's easy to dodge Sonic Wave by using Blink Strike & Tricks of the Trade.

* With Smoke Screen, Riki will silence and catch Medusa in a surprise with high miss chance flushing her from positions easily in team fights.
* He can deal a huge amount of damage through Cloak and Dagger, even through Mana Shield.

* A good Nyx can reflect Queen of Pain's Sonic Wave with his Spiked Carapace, or even initiate a gank on her in Vendetta while she farms a creep wave with Scream of Pain.
* Her strength to intelligence ratio is bad enough that he should be able to kill her without even requiring a Dagon, provided he can get his full combo off.

* Vendetta burns a significant amount of mana on hit, and the damage from the ability drains Medusa's mana pool even further.
* Due to the passive nature of Mystic Snake and Split Shot, it can possibly proc Nyx's Spiked Carapace if he's within range of Medusa's abilities and isn't invisible.
* Medusa lacks single target damage, making Nyx with Aghanim's Scepter extremely hard to deal with if Medusa is the team's main damage source.
Additional:
* With her passive Split Shot, Medusa can be easily interrupted by Spiked Carapace during combat, especially during her precious Stone Gaze.
* Mana Burn quickly destroys Mana Shield, especially if Medusa only increases her mana pool by bolstering intelligence (which has the added bonus of increasing Mana Burn's damage).
* Uncontrollable damage from Mystic Snake and Split Shot can trigger Spiked Carapace.
* Medusa lacks single target damage, making a Burrowed Nyx Assassin hard to kill.

* Queen of Pain's intelligence is very vulnearble stealing after Silencer kill her with Glaives of Wisdom and influence mana regen and mana pool from her.

* Silencer burns easily through her effective HP from Mana Shield, by taking away her intelligence.
* Arcane Curse punishes her repeatedly casting Mystic Snake to keep her mana pool high. He can force her to use Manta Style before he has cast Global Silence and Medusa usually does not want to build Black King Bar.

* Heroes that depend on disrupting fights with ability combos or big ultimate abilities are vulnerable to the long stun of Fiend's Grip: Disruptor, Death Prophet, Enigma, Faceless Void, Invoker, Lich, Magnus, Mars, Medusa, Outworld Destroyer, Phoenix, Puck, Queen of Pain, Shadow Fiend, Treant Protector, Underlord, Winter Wyvern, Witch Doctor, Zeus.

* Fiend's Grip provides mana drain, which can heavily damage Mana Shield and prevent Medusa from using Stone Gaze.
* Even if she does use Stone Gaze, Nightmare can buy enough time to protect allies and reset the fight.
Additional:
* Fiend's Grip leaves Medusa defenseless, since not only does it deal damage, it also drains mana.

* High priority targets like Queen of Pain, Drow Ranger, Ember Spirit can't get caught out from Lion's long range disables, making it harder to them fulfill their roles, and making it easy to target them.

* Medusa lacks mobility or escape mechanisms. Earth Spike and Hex can neutralize her strong damage potential and allow for Lion's team to focus her down.
* In addition to easily breaking her commonly bought Linken's Sphere with its low cooldown, Mana Drain can quickly drain her Mana Shield, making her far less tanky.
* Mana Drain, along with Hex, destroy illusions instantly, which may be extremely helpfull and efficient against core builders of Manta Style, like Medusa herself.

* Ghostship helps your team soak up damage from Sonic Wave and Scream of Pain.
* Queen of Pain can't escape easily from X Marks the Spot - Torrent combo.
* Outlanes Queen of Pain on the midline, due to the fact that Queen of Pain has a small reserve of health at the beginning of the game, and she suffers very much from Tidebringer, which is why she is forced to either spend money on Tango, or skip creeps and run for bounty runes, and Kunkka at this time will gain an advantage in level and gold.
Additional:
* Outlanes Queen of Pain on the midline, due to the fact that Queen of Pain has a small reserve of health at the beginning of the game, and she suffers very much from Tidebringer, which is why she is forced to either spend money on Tango, or skip creeps and run for bounty runes, and Kunkka at this time will gain an advantage in level and gold.
* Kunkka will catch her in X Marks the Spot and allow his team to kill her for stun from Torrent, because Queen of Pain has no way to avoid the cross X Marks the Spot before buying Black King Bar.

* Phantom Lancer with Diffusal Blade will very quickly burn Medusa's mana, making Mana Shield significantly less effective.
* Doppelganger's 1 second invulnerability can be used to dodge Medusa's petrification from Stone Gaze, as well as Mystic Snake.
* Phantom Lancer's illusions outnumber Medusa's targets from Split Shot, likely shielding his team in the process.

* Webbed areas can be used to hit and run, covering distance hastily weakening her on the way and initiating ganks.
* Even though Medusa can hunt down Spiderlings easily when given enough range, Silken Bola will cause her attacks to miss and get her swarmed in no time.
* Medusa usually does not build a Black King Bar to benefit from Mana Shield fully while Broodmother can fit a Diffusal Blade to burn away all of Medusa's mana.
Additional:
* Spin Web will allow Broodmother to pick her own fights and sometimes slip away to ambush Medusa.
* Though Medusa's Split Shot and Mystic Snake can help Medusa deal with Broodmother's spiderlings, Broodmother will create too much of them for her to handle, allowing her to outnumber Medusa's targets from Split Shot and shield her team in process.

* Shadow Shaman has many disables to lock down Queen of Pain, preventing her from Blinking away, even through Linken's Sphere or her spell block talent.
* Mass Serpent Ward can tear through Queen of Pain's low health pool once she's locked down by Hex & Shackles.

* Night Stalker has a huge, almost instant silence through Crippling Fear. The main problem is that he can get it off while Queen of Pain barely has any vision of him if he creeps up to her during Dark Ascension. She'll have to play very carefully before she gets a Black King Bar or a Eul's Scepter of Divinity.

* A good Centaur can catch Queen of Pain with a Blink Dagger and Hoof Stomp.
* Retaliate with Blade Mail reflects all of Queen of Pain's damage, especially Sonic Wave.
* Stampede grants a movement speed bonus, which can prevent Queen of Pain from initiating.
* Double Edge can shred her low health pool if she's not careful.

* A good Skywrath Mage with quick fingers will punish Queen of Pain for blinking aggressively. Ancient Seal is a six second silence with no cast time, so he can interrupt either her Shadow Strike or Sonic Wave, and a good Mystic Flare on top of that will seal the deal for her.
* Ancient Seal also has pretty good range so he could get it off before she blinks away.

* Time Dilation affects Queen of Pain's low cooldown abilities, making them unusable for a long time, rendering Queen of Pain nearly useless.
* Chronosphere provides excellent lockdown against Queen of Pain, allowing for reliable kills in all stages of the game.
Additional:
* Time Walk and Backtrack allows Faceless Void to easily negate Queen of Pain's burst damage.
* Chronosphere prevents Queen of Pain from escaping with Blink, and her low survivability makes her an easy kill.
* Time Dilation will prevent Queen of Pain from using her low-cooldown spells or force her to buy Black King Bar or a Eul's Scepter of Divinity to dispel the debuff and re-engage.

* Ursa's status resistance from Enrage reduces duration of Medusa's Stone Gaze.
* Ursa can stack damage with Fury Swipes easily against her Mana Shield in a prolonged team match.
Additional:
* Medusa's tankiness doesn't help her very much against Fury Swipes in long teamfights.
* With no escape mechanism and a slow movement speed, getting jumped on by Ursa usually spells a quick end for Medusa in the early game.

* Blink and positioning is crucial for Queen of Pain. These factors are heavily countered by a good Glimpse.
* Static Storm is devastating for Queen as she relies heavily on her spells to inflict heavy burst damage.
Additional:
* Thunder Strike gives vision of Queen of Pain when she's trying to escape. When combined with Glimpse, her mobility and hit-and-run style can be negated.
* While in a team fight, Static Storm forces Queen of Pain to only use right-clicks.
* When combined with the Kinetic Field, she can only wait until she respawns.

* All her abilities can stealing by Rubick with Spell Steal.
* Rubick's always purchase Blink Dagger can catch up Queen of Pain's and since Rubick's get stealing Blink, Rubick's makes escape twice blink or since Rubick's get Aghanim's Shard,Rubick's Telekinesis can save him although Blink and Blink Dagger cooldown.

* Heroes that build Diffusal Blade or can fit it well into their item build will also make Medusa much less tanky: Riki, Naga Siren, Terrorblade, Juggernaut, Spectre, Slark.

* Hard carries who just want to farm and be left alone will not appreciate Primal Beast, heroes such as Medusa, Drow Ranger...

* Other heroes who has armor and slow debuffs won't allow Medusa to disengage from combat: Tidehunter, Bristleback, Slardar.

* Heroes with gap-closing abilities will be easy targets for Berserker's Call: Phantom Assassin, Faceless Void, Slark, Chaos Knight, Morphling, Queen of Pain

Additional:
* Berserker's Call prevents Queen of Pain from escaping with Blink and also pierces her Black King Bar.
* Due to her fast attack speed from Mjollnir, it will quickly trigger Counter Helix.
* Culling Blade finishes off Queen of Pain's low health pool before she gets a chance to escape, preventing her from playing the hit-and-run style often associated with Queen of Pain.

* Axe can take advantage of Medusa's awfully low HP to insta-kill her with Culling Blade, making it extremely difficult for her to farm for items to compensate for the lack of strength during early and mid-game while Axe is continuously harassing around.

* In early to mid stage, Silence is also a great way to counter escape oriented heroes such as Anti-Mage, Queen of Pain, and Phantom Assassin to prevent them from escaping, provided that they don't have any basic dispels.

Additional:
* Silence will prevent Queen of Pain from using Blink to escape or chase.
* If Queen of Pain uses Blink to close the gap to Death Prophet, Death Prophet will be in range for Spirit Siphon and typically gain an advantage over Queen of Pain.

* Heroes with blink or movement abilities, which are disabled by Pounce's leash: Anti-Mage, Earth Spirit, Faceless Void, Magnus, Mirana, Monkey King, Morphling, Pangolier, Phantom Assassin, Phoenix, Puck, Queen of Pain, Riki, Sand King, Spirit Breaker, Timbersaw, Tusk.

* Medusa is especially vulnerable to Essence Shift, as both strength and intelligence contribute to her effective HP, while agility contributes to her damage.
* Dark Pact when timed right can be used to dispel Stone Gaze right after it petrifies Slark, allowing him to keep attacking Medusa throughout the duration.
Additional:
* Medusa cannot chase Slark in any way and has no disable beyond her ultimate, making her unable to stop him getting away and regenerating before coming back to finish her off.
* Essence Shift particularly removes 1 intelligence point per hit, thus lowering Medusa's mana pool's cap and leaving her much more vulnerable in prolonged fights.

* Heroes with mobility spells like Queen of Pain, Anti-Mage, Phantom Assassin, Riki, Puck, and Spirit Breaker that are cancelled by Frostbite can suffer greatly from the presence of Crystal Maiden. It is absolutely critical, however, to have followup from teammates, as all of the above heroes can make quick work of the squishy Crystal Maiden after they are released from her grip.

* Other heroes who has armor and slow debuffs won't allow Medusa to disengage from combat: Tidehunter, Bristleback, Slardar.

* Heroes that build Diffusal Blade or can fit it well into their item build will also make Medusa much less tanky: Riki, Naga Siren, Terrorblade, Juggernaut, Spectre, Slark.

* Lina has a very long range of attack, which completely overlaps the range of Queen of Pain's abilities and attacks, which is why even a single Shadow Strike roll can become deplorable, since Lina will shoot Queen of Pain from a long distance before and after the Shadow Strike roll. And with the help of the abilities of Light Strike Array and Laguna Blade, Lina can even kill Queen of Pain because of her small health reserve if she is exposed to a blow
Additional:
* Lina has a very long range of attack, which completely overlaps the range of Queen of Pain's abilities and attacks, which is why even a single Shadow Strike roll can become deplorable, since Lina will shoot Queen of Pain from a long distance before and after the Shadow Strike roll. And with the help of the abilities of Light Strike Array and Laguna Blade, Lina can even kill Queen of Pain because of her small health reserve if she is exposed to a blow

* Sniper can outrange both Medusa's arrows and Stone Gaze, allowing him to focus her down during a teamfight.
Additional:
* Medusa is a fairly immobile hero that deals damage around her with Split Shot. Sniper should outrange her and should stay out of harm's way from Split Shot.
* More importantly, Sniper should have enough attack range to fire at Medusa during her Stone Gaze without turning to stone, so the ultimate is mostly wasted against him.

* Bulwark can make each of Medusa's attacks target him instead, reducing Medusa's contribution on team fights.
* Spear of Mars stuns Medusa and also pushes her away from teamfights, taking advantage of Medusa's low mobility.
* Arena Of Blood blocks Medusa's attacks from outside the arena.

* Heroes that rely on escapes to stay alive can be caught and locked down for a long time: Queen of Pain, Phantom Assassin

* Heroes that rely on their high mobility such as Queen of Pain, Slark and Weaver can be constantly engaged against due to your excellent ability to chase over any terrain. Make sure you carry true sight items (such as Dust of Appearance or Gem of True Sight) for invisible heroes that could potentially escape your clutches.

* Heroes reliant on abilities to output damage or escape can be shut down by Gust: Queen of Pain.

* Heroes who take a long time to become strong are in for a rough mid game, such as Outworld Destroyer, Magnus, Medusa, and Anti-Mage.

* Heroes that have escape abilities (such as Queen of Pain, Storm Spirit or Timbersaw) can be either nullified by Reaper's Scythe or a complimentary item for Necrophos (like Rod of Atos or Scythe of Vyse). If Necrophos is quick enough and enters range, they can quickly, if not instantly, die if they are not quick enough.

* Heroes that build Diffusal Blade or can fit it well into their item build will also make Medusa much less tanky: Riki, Naga Siren, Terrorblade, Juggernaut, Spectre, Slark.

* Heroes who rely on high mobility are especially vulnerable to Primal Roar: Storm Spirit, Ember Spirit, Queen of Pain.

* With Static Link, Razor can effectively make Medusa useless in teamfights by reducing her main damage output. It can, however, be blocked by a Linken's Sphere.
* Plasma Field allows Razor to get on top of Medusa, slowing her already slow movement speed to a mere crawl.
* Eye of the Storm capitilizes on Medusa's low armor and causes her to be very vulnerable, even through Mana Shield.

* Any Hero with high mobility will be neutralized by dream coil: Queen of Pain, Storm Spirit, Ember Spirit, Lycan, Bloodseeker, Anti-Mage, Timbersaw.

Additional:
* Puck will make a game of dodging as many Shadow Strikes as he can with Phase Shift. If he's a good player, he will also dodge Sonic Wave. If he's a great player, he will also dodge Scream of Pain. All through a single spell.
* Puck also has a silence to stop her blink with Waning Rift.
* Puck will have vision to hunt her down if she blinks into the trees with Illusory Orb.
* If Queen of Pain is under the effect of Dream Coil, she will be unable to blink out.

* Heroes who recklessly jump on Pudge with their gap-closing abilities will be easy targets for Pudge's Meat Hook and Dismember Combo: Phantom Assassin, Faceless Void, Queen of Pain etc.

* Heroes with extremely slow movement speed will cripple against Solar Bind: Medusa, Viper

Additional:
* Will-O-Wisp will keep Medusa busy after she got hit by Blinding Light.

* Duels prevents Queen of Pain from using Blink, which may force her to purchase a Linken's Sphere
* Because Queen of Pain is also not a right-click hero, Legion won't have much difficulties in duels.
* Press the Attack dispels Shadow Strike's debuff.

* Heroes that build Diffusal Blade or can fit it well into their item build will also make Medusa much less tanky: Riki, Naga Siren, Terrorblade, Juggernaut, Spectre, Slark.

* Blood Rite prevents Queen of Pain from escaping with Blink.
* Blink will trigger the extra damage from Rupture.
Additional:
* Blood Rite silences her, preventing her from initiating or escaping.
* With Thirst, even if she Blinks away, Bloodseeker can catch right up to her.
* Rupture will heavily damage Queen of Pain if she tries to Blink away.
* She is, however, one of the few heroes who can avoid the damage from Rupture if she successfully blink-walks.

* E.M.P. allows Invoker to burn Medusa's mana to weaken Mana Shield.
* Medusa's lack of mobility makes her easy to kite with Invoker's spells.
Additional:
* E.M.P. is a large mana burn nuke which can hit Medusa's Mana shield with enough damage to lose even more mana.
* Deafening Blast disarms Medusa's ability to deal pseudo-AOE damage during teamfights.
* Cold Snap allows the opposing team to repeatedly stun Medusa in short succession, preventing her from successfully casting her ultimate due to its long cast time.

* Aggressively blinking is not going to end well against Luna, because Queen of Pain will be an easy target for Lucent Beam & Eclipse.
* Queen of Pain's HP is abysmal, so Luna can quickly kill Queen of Pain as soon as she initiates with Blink.
Additional:
* Aggressively blinking is not going to end well against Luna, because Queen of Pain will be an easy target for Lucent Beam & Eclipse.
* Queen of Pain's HP is abysmal, so Luna can quickly kill Queen of Pain as soon as she initiates with Blink.

* Burning Spear's damage over time can rapidly burn Medusa's mana and health alike.
* Inner Fire can slow and disarm Medusa and also allow Huskar to follow up with Life Break.

* Other heroes who has armor and slow debuffs won't allow Medusa to disengage from combat: Tidehunter, Bristleback, Slardar.

* Chain of Earthbinds prevents her from using Blink, allowing Meepo to quickly kill her with Poof and attacks.
* Meepo tends to buy items with attributes, mitigating Queen of Pain's magical burst.
Additional:
* Meepo is the hard counter for Queen of Pain - chaining Earthbinds prevents her from using Blink for a long time, and without any other escape options, Queen of Pain cannot survive several Poofs and attacks.
* Meepo tends to build items with attributes, mitigating Queen of Pain's magical burst.