In Classic Pyramid, the cards are initially dealt to the table in the form of a pyramid consisting of seven rows of cards. The top row contains one card, the second row contains two cards, and so on, until the seventh row which contains seven cards. The cards at each row block the cards on the row above it. The goal is to eliminate cards by selecting pairs of cards that sum to 13. The remaining cards in the stock can be turned to a playing pile from which you may use the top card for elimination. To increase your score, you should try to finish the patience in as short time as possible.

The patience has three different settings: turn three, turn one and turn three then one. In the first version you turn three cards at a time from the stock to the playing pile and in the second version you turn one card at a time. In both of these versions you may recycle the playing pile to the stock when there are no more cards left in it. In the third version you start by turning three cards at a time. When the stock is empty you may choose to recycle the playing pile to the stock and then continue turning three cards at a time, or you may choose to recycle and start turning one card at a time. When switching to turning one card you may however not recycle the playing pile the next time around.