In SIXGEMS, players play gem cards to a tableau in front of them in order to manipulate dice around a central area. The gem cards show die faces that affect which dice can be moved, and if their face is adjusted. The players then have the option to play an account settlement card which may grant certain bonuses, but also triggers a scoring where players earn points for the gems they hold corresponding to the location and face of the blue dice, and lose points in the same manner for the red die. After a certain number of account settlements have been triggered, the game ends and the person with the most points wins.