Pai gow poker is a take on the Chinese domino game, gai gow. Played with a 53-card deck, which includes the joker, Pai gow poker is played is one on one, with the player competing for the best hand against the dealer.

The game begins with players making their bet, to which the dealer gives each player seven cards. A roll of the dice or a randomly generated number determines which player gets the first set of cards. Players then arrange their cards into a five and a two-card hand. The five-card hand is ranked as in poker. The two-card hand will either be a pair or two individual cards.

After all the players have arranged their hands, the dealer arranges his hand according to a set of fixed rules known as the "house way." Then each of the players’ five-card hands and two-card hands are compared to the dealer's five- and two-card hands. The highest hands win. In the event of a tie, or an exact match, the dealer wins. If the player beats the dealer with both hands the player wins even money, less a 5% commission. If the player wins one and loses one the bet is a “push.” If the player loses both the player loses the entire wager.

When setting up, the player’s two-card hand may not be higher then the five-card hand. If it is, then both hands are deemed "foul" and both lose. The joker can only be used to complete a straight, flush, or straight flush; otherwise it is treated as an ace. At some casinos, if there is an empty seat at the table, the dealer will also deal a "dragon" hand. Another player may assume the dragon hand if they wish, essentially playing two positions rather than one. The player may have to use the “house way” in setting the dragon hand.

In pai gow poker any player may elect to be the banker in turn. If a player banks, the 5% commission is charged on the net win. When a player is the banker the dealer will still play, betting an amount equal to the last bet the player made when the dealer was the bank. The opportunity to bank usually rotates from person to person, including the house, but will sometimes switch between the players and the dealer. If the player wants to bank, they must have enough money on the table to pay off all winning bets. The player must also have played a previous hand against the house banker to bank. Some casinos will even allow a player to co-bank with the house, splitting the payout responsibility.

Pai Gow Poker is a very popular online casino game!