It is difficult for any ad blocker to block ads on Twitch. Since Twitch ads are inserted directly into the video stream, ad blockers must “race” to block ads on Twitch streams before the site can download them. This means that while AdBlock does block Twitch ads, we may not be able to catch every single ad before you see it. If you see occasional unblocked ads on Twitch while using AdBlock, a simple page refresh should eliminate them. — Kat C., AdBlock Support