Today video poker enjoys a prominent place on the gaming floors of many casinos. Video poker first became commercially viable when it became economical to combine a television-like monitor with a solid state central processing unit. Video poker became more firmly established when SIRCOMA, which stood for Si Redd Coin Machines, and which evolved over time to become International Game Technology, introduced Draw Poker in 1979. Throughout the 1980s, video poker became increasingly popular in casinos, as people found the devices less intimidating than playing table games.

Game play begins by placing a bet of one or more credits, by inserting money (or in newer machines, a barcode paper ticket with credit) into the machine, and then pressing a "Deal" button to draw cards. The player is then given an opportunity to keep or discard one or more of the cards in exchange for a new card drawn from the same virtual deck. After the draw, the machine evaluates the hand and offers a payout if the hand matches one of the winning hands in the posted pay schedule. Some machines offer progressive jackpots for the royal flush, (and sometimes for other rare hands as well), thereby spurring players to both play more coins and to play more frequently.

Newer video poker machines may employ variants of the basic five-card draw. Typical variations include Deuces Wild, where a two serves as a wild card and a jackpot is paid for four deuces or a natural royal; pay schedule modification, where four aces with a five or smaller kicker pays an enhanced amount (these games usually have some adjective in the title such as "bonus", "double", or "triple"); and multi-play poker, where the player starts with a base hand of five cards, and each additional played hand draws from a different set of cards with the base hand removed. (Multi-play games are offered in "Triple Play", "Five Play", "Ten Play", "Fifty Play" and even "One Hundred Play" versions.)