Sette e mezzo is played with a 40-card deck, a standard deck with eights, nines, and tens removed. The value of cards ace through seven is their pip value (1 through 7), face cards are worth ​1⁄2 point each. Players compete against the dealer, but not against each other. The objective of the game is to beat the dealer in one of the following ways:

Get 7​1⁄2 points on the player's first two cards (called a reale or natural), without a dealer natural 7​1⁄2;
Reach a final score higher than the dealer without exceeding 7​1⁄2; or
Let the dealer draw additional cards until their hand exceeds 7​1⁄2.
The score of each player’s hand is calculated by adding the points of their cards.

The bank plays against all the other players; so, if the bank has passed, all the other players who have stood win their bets.

If the bank stands, the cards are compared. The goal is to reach the nearest amount of points to seven and a half. If both have the same amount, the bank wins; in particular, if the bank gets seven and a half, there is no need to view the cards of the remaining players.

The bank pays the bet to the players who have got a better game, and the other way round.

The player who gets seven and a half, if the bank does not get it, is paid the double of the amount, and becomes the new bank in the next deal.