In standard lowball (also called California lowball) the best low hand is A,2,3,4,5, followed by A,2,3,4,6; then A,2,3,5,6; etc. Frequently the joker is used as a wild card. In deuce-to-seven lowball the best low hand is 2,3,4,5,7.

Each player receives five cards face down. There is a round of betting, starting with the player to the dealer's left. Ordinarily the rules require that the player to the dealer's left bet blind.

After that betting round, players may draw up to five cards. Following the draw, there is a final round of betting. Usually the rules of play require a 7 low or better to bet in order to win any money put into the pot after the draw.

The lowest ranking hand in the showdown wins the pot. In standard lowball, straights and flushes are ignored. However, in deuce-to-seven lowball they count and therefore are not considered a low hand. In standard lowball the ace is a low card; in deuce-to-seven it is a high card. Another lowball variation makes A,2,3,4,6 the best low hand and counts straights and flushes as high hands.