Sick-O

It’s like Omaha Hi-Lo, except the low is played deuce-to-seven

You know Omaha Hi-Lo: four hole cards, exactly two from your hand and exactly three from the board, half the pot to the best high, half to an 8-or-better low where aces are low and A-2 is gold. Sick-O keeps all of that except the low half. There, the WSOP rule sheet says, “Sick-o has a 9 qualifier and is played as a 2-7 hand. When playing low, Aces are high, straights and flushes count against you.”

That sentence turns the low half inside out. The A-2 that made you happy in O8 is now a pair of cards you probably didn’t want.

Everything on this page comes from one source, the WSOP live-action rule sheet. We found no second room, article or festival list that describes the game.

30-second cheat sheet

• Everything about Omaha Hi-Lo applies except the low half: four hole cards, exactly two from your hand and exactly three from the board, high half and low half.
• The low is a deuce-to-seven low: aces are always high, and straights, flushes and pairs all hurt you.
• Best possible low: 7-5-4-3-2, not all one suit. (2-3-4-5-7 is not a straight.)
• The low has a 9 qualifier. The WSOP doesn’t spell out what that means in 2-7 terms. Our reading is below, and it’s labeled as ours.
• No qualifying low: the best high takes the whole pot.
• Eight players maximum (WSOP). The WSOP names no betting structure.
• Rare: the WSOP’s sheet is the only place we found it.

Full rules

The deal

Same as Omaha Hi-Lo. “All the rules of Omaha High-Low apply to Sick-o,” says the WSOP, except for the low. Button and blinds, four hole cards each, a betting round, then flop, turn and river with a round of betting after each. The WSOP text gives no betting structure for Sick-O, so it’s played in whatever structure the game or Dealer’s Choice picks. Omaha Hi-Lo is typically limit or pot-limit, but that’s our inference, not the rule sheet’s.

The high half

Ordinary Omaha high: exactly two hole cards plus exactly three board cards, best five-card hand.

The low half

Per the WSOP, the low is a 2-7 hand with a 9 qualifier. Here’s what that means, reading it the usual way:

• Five cards, made from exactly two hole cards and three board cards (the Omaha rules apply to the low too, and you may use different hole cards than your high).
• Ranked deuce-to-seven. Lowest hand wins, aces are always high, and straights, flushes and pairs make a hand worse. The nuts is 7-5-4-3-2 with at least two suits.
• A 9 qualifier. We read this as: the highest card in the five-card low has to be a 9 or lower, with no pair, no straight and no flush. Under this reading the worst qualifying hand would be 9-8-7-6-4, because 9-8-7-6-5 is a straight. That reading is ours. The WSOP text doesn’t say whether a paired, straight or flush hand can qualify, or how “9 qualifier” works under 2-7 rules. If it comes up, ask the floor.

If nobody qualifies for low, the best high wins the whole pot. That rule is inherited from WSOP Omaha Hi-Lo.

Ties and the odd chip

Inherited from WSOP Omaha Hi-Lo and the general rules. Tied hands in a half split that half evenly, so you can get quartered. The odd chip goes to the high hand in a high/low split.

Rooms disagree

Nothing to compare, because there’s no second source. The only ambiguity is inside the WSOP text itself: the exact meaning of “9 qualifier” under 2-7 rules is undefined (see above). Several Omaha Hi-Lo variants with a 9 or 7 “ceiling” exist in other places (Wikipedia and online help pages describe them), but those are ace-to-five lows, which is a different animal from Sick-O’s 2-7 low.

How you’ll embarrass yourself

• Playing the low as ace-to-five. Aces are high here. A-2-3-4-5 is just an ace-high straight, a bad low.
• Forgetting that straights and flushes ruin a low. 2-3-4-5-6 is a straight, which is terrible, not wonderful.
• Treating it as 8-or-better. The 9 qualifier is looser, but 2-7 lows are harder to make because of the straight, flush and pair penalties.
• Using Omaha Hi-Lo habits. A-2 is not the key hand. The good low hole cards are the deuce through the seven that don’t make straights or flushes with the board.
• Assuming everyone knows the game. The WSOP sheet is the only place we found it.

Lore and reputation

Not much, honestly. Sick-O appears only in the WSOP 2026 Live-Action Rules, in the list of Omaha variants. We found no room rule sheet, festival list or article describing it. The Cardplayer Lifestyle Mixed Game Festival list doesn’t name it. Treat it as a niche novelty.

The name looks like a pun on “Omaha” and “sick,” possibly nodding at the 2-7 lowball hands. That’s a guess. No source we found explains the name.