In Karma, each player is dealt three face-down cards that they cannot look at and that remain on the table in front of them. They are dealt six more cards, choose three of those for their hand, and place the remaining three face-up onto their table cards in three separate stacks. One player begins by placing a card or cards of the same value from their 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 their face-up table cards, which must in turn be played before any of their face-down table cards. A few cards allow players to break the foregoing rules. The last player with cards loses the game.