2 to 8 players.
Standard 52-card deck.
To avoid being the player who ends the game holding the Old Maid.
Remove three of the queens from the deck. The remaining queen is the Old Maid.
(Alternatively, remove just one queen from the deck. The remaining queen of that same color is the Old Maid.)
Choose a dealer.
Deal the cards as evenly as possible among the group. It's acceptable for some players to have more cards than other players.
Players sort their cards and discard any pairs. (If a player has three of a kind, he discards two of the cards and keeps the third).
The dealer then offers his hand, face down, to the player on his left. That player randomly takes one card from the dealer. If the card matches one he already has in his hand, he puts the pair down. If not, he keeps it.
Play proceeds clockwise, so the player to the left of the dealer then offers his hand, face down, to the player on his left. This cycle repeats until there are no more pairs and the only remaining card is the Old Maid.
The game ends when the Old Maid is the only card in play. The person holding the Old Maid loses.