The Joker card is counted as an Ace, but can count as any card for the purposes of completing a Straight, Flush, Straight Flush or Royal Flush. Pai Gow Poker is played with a standard 52 card deck and an additional Joker card. All players playing at a Pai Gow poker table play against the house. Pai Gow Poker is a casino poker game that resulted from a combination of game elements from classic player vs player poker and traditional Chinese Pai Gow dominos.