Take out all of the face cards except ONE queen.
Deal all the cards out to all the players.
Try not to be the person with the Queen card at the end of the game.
Each player removes all their pairs. If someone has three of a kind, only remove two of them. Youngest player goes first and takes a card from the player on their left. If it matches another card, take out the pair. Then move on to the next player. Continue until everyone has matched their cards and one person is left with the Queen card.
If you are playing with a deck without a set of queens, choose another number to represent the "Old Maid," and keep only one of that card (take out the other 3 in the set).