The game of Pai Gow is played with a set of 32 tiles also referred to as cards. The house pre-determines the way in which their hands are set and allows the players to share in the banking of the game. This lets players take a piece of the action and, at times, gain a small advantage.

Pai Gow dates from ancient times. Pai Gow piques the curiosity of some Westerners because its tiles resemble dominoes tiles. Knowledge and proficiency of this game bring a dealer's marketability to a high level. Higher-echelon casinos view Pai Gow dealers as a special commodity.

Dealing Pai Gow requires great skill and patience. Most Pai Gow games are offered in higher end casinos that set their table limits very large. The game is very interesting and fun once the dealer has mastered the techniques involved with its operation.