Game play begins by placing a bet of one or more credits, by inserting money (or in newer machines, a barcoded paper ticket with credit) into the machine, and then pressing a "Deal" button to draw cards. The player is then given an opportunity to keep or discard one or more of the cards in exchange for a new card drawn from the same virtual deck. After the draw, the machine evaluates the hand and offers a payout if the hand matches one of the winning hands in the posted pay schedule.

On a typical video poker machine, payouts start with a minimum hand of a pair of jacks. Pay tables allocate the payout for hands based partially upon how rare they are, and also based upon the total theoretical return the game operator chooses to offer.

Some machines offer progressive jackpots for the royal flush, (and sometimes for other rare hands as well), thereby spurring players to both play more coins and to play more frequently.

Newer video poker machines may employ variants of the basic five-card draw. Typical variations include Deuces Wild, where a two serves as a wild card and a jackpot is paid for four deuces or a natural royal; pay schedule modification, where four aces with a five or smaller kicker pays an enhanced amount (these games usually have some adjective in the title such as "bonus", "double", or "triple"); and multi-play poker, where the player starts with a base hand of five cards, and each additional played hand draws from a different set of cards with the base hand removed. (Multi-play games are offered in "Triple Play", "Five Play", "Ten Play", "Fifty Play" and even "One Hundred Play" versions.)

In the non-wild games (games which do not have a wild card) a player who plays five or six hundred hands per hour, on average, may receive the rare four-of-a-kind approximately once per hour, while a player may play for many days or weeks before receiving an extremely rare royal flush.

A poker machine with auto-read will help you with the poker odds in real-time while playing online poker.