If you are already familiar with either pai gow or poker, then you will have absolutely no trouble learning and enjoying this game. That said, Pai Gow Poker, which is essentially the Americanized version of the game, is a combination of pai gow and the regular game of poker that we know and love. Pai gow is originally an ancient Chinese gambling game that is played with tiles that resemble dominoes. In the United States and several other parts of the world, the first thing that comes to mind when Pai Gow is mentioned is Pai Gow Poker, otherwise referred to as Double-Hand poker.