In Karma, each player is dealt three face-down cards that he cannot look at and that remain on the table in front of him. He is dealt six more cards, chooses three of those for his hand, and places the remaining three face-up onto his table cards in three separate stacks. One player begins by placing a card or cards of the same value from his hand onto the table face-up to create a discard pile. The other players in turn must place onto the discard stack a card or cards of the same value that match(es) or exceed(s) the value of the top card of the stack; or else, pick up the stack. Until the draw pile is gone, players must draw at the end of their turns to maintain a hand of at least three cards.

All of a player's hand cards must be played before any of his face-up table cards, which must in turn be played before any of his face-down table cards. A few cards allow players to break the foregoing rules. The last player with cards loses the game.