Hypoxia is a multiplayer virtual reality comparison card game that mixes strategy, social deduction, and a little bit of luck. Each round, players draw a randomized hand of cards and must bet oxygen (poker-style) in the hopes of finishing with the highest score and taking the pot. Cards are valued from one to five and have one of three element types: wood, water, or fire. The elements form a triangular relationship: wood beats water, water beats fire, and fire beats wood. Card values increase depending on the number of cards from the element they counter that are currently in play. For instance, if two wood cards are in play, a fire card with an initial value of three would be boosted to five.

The game is implemented without game states and uses diegetic control elements; thus, it is entirely player-driven, allowing users to emulate the table-top feel in a stylized, immersive atmosphere.