1. Set Up the game: Gather all the cards, shuffling them and then placing them face down in a pile in the center of the playing area.
2. Determine the number of players: Extreme KitTen can be played with 2-6 players.
3. Determine the number of rounds: Each round consists of 2-3 Turns.
4. Deal the cards: Deal out the cards, one at a time, to each player, until all the cards are dealt.
5. Play the game: The object of the game is to be the first player to get rid of all their cards. On their Turn, players can either play a card from their hand that matches the card on The Top of the discard pile (by either color or number), or draw a card from the pile. If they cannot play a card, they must draw one from the pile. When a player has no more cards in their hand, they win the round.
6. Score the round: At the end of each round, the winner gets one Point.
7. Play multiple rounds: Play multiple rounds until one player reaches a predetermined score (usually 5 or 7 Points). The player with the most Points at the end of the game wins.