Pai gow poker is a variation of the Chinese domino game pai gow. Pai gow poker is commonly referred to as simply "pai gow", which is wrong, as "pai gow" alone is a completely separate game. Pai gow poker is played with a 53-card deck, including a joker. The game is one on one, the players against the banker, each competing to make the best possible hands. Due to a rather slow pace and a lot of ties, pai gow poker is less intense than most casino games and a modest buy in can usually last a long time.

The object of Pai Gow poker is for a player to create two poker hands out of the seven-card hand heor she is dealt by the dealer: a five-card hand, and a two-card poker hand. The five-card hand's value must exceed the two-card hands. The two-card hand is often called the hand "in front" or "on top" or "hair", or the "small" or "minor" or "low" hand. The five-card hand is called the hand "behind", or the "bottom" or "high" or "big" (as they are placed that way in front of the player, when the player is done setting them).