In Piranha Flip, you must escape the piranhas or become fish food.

To set up, shuffle the double-sided piranha cards and give one to each player, along with five bandage tokens. Place the top card of the deck in the middle of the table. On your turn, place your card on the table with either side face up, then flip over all other cards on the table of the same color. If at least ten piranhas in a single color are now visible, this swarm attacks you, costing you tokens based on the size of the swarm. Draw a card to end your turn.

When a player runs out of tokens, the game ends and whoever has the most tokens wins.

Piranha Flip includes a co-operative variant.