Five-Card Stud was the game of the Old West and is the game best known to movie-goers (It was the game in the classic poker movie The Cincinnati Kid), with the possible exception of Draw. It is almost never spread anymore, but is included here both because it provides a reference point for those familiar with the game, and because it is one of the poker games permitted by various state gaming authorities. Because of its place in the history of the game of poker it is an important foundation of the rules of poker.

All the rules of Seven-Card Stud apply to Five-Card Stud. Players receive two cards to start, an upcard and a downcard. This is followed by a betting round. Players then receive three more upcards one at a time, each followed by a betting round, for a total of four betting rounds. Sometimes the game is spread with the last card dealt as a downcard rather than an upcard. The bet doubles on the third upcard unless there is an open pair on the second upcard, in which case the same rules as in seven card-stud apply relative to increasing the limits. The game can be played high-low split, with Aces playing both high and low.