Place the start tile down in the middle of the table between all players. Shuffle the deck and deal out five cards to each player. During a player's turn, that player draws a card off the top of the tapeworm deck. Then they may play a card that attaches to any open segment on the table. If the card they attached to doesn't end or change color, then they may attach another card of the same color and continue until they place a card that ends the color sequence or they no longer have any cards of that color to play on the sequence.

The first player to have no cards in hand at the end of their turn wins! From Edmund McMillen, the creator of Super Meat Boy and The Binding of Isaac!