The original game is also commonly known as 'Omaha high'. In North American casinos, the term 'Omaha' can refer to several poker games.

The 'Omaha' part of the name represents this aspect of the game. Across all the variations of the game, the requirement of using exactly two hole cards is the only consistent rule. This version of Omaha is defined in the glossary of Super/System (under Omaha) as being interchangeable with ' Tight hold 'em'. In the original Omaha poker game, players were only dealt two hole cards and had to use both to make a hand combined with community cards. This is opposed to draw games, where each player's hand is composed only of concealed cards, and stud games, where each player's unique hand contains a mix of cards visible to the other players and concealed hole cards. 'Hold'em' refers to a game using community cards that are shared by all players. Omaha hold 'em derives its name from two types of games.

Omaha hold 'em 8-or-better is the 'O' game featured in H.O.R.S.E. The exact origin of the game is unknown, but casino executive Robert Turner first brought Omaha into a casino setting when he introduced the game to Bill Boyd, who offered it as a game at the Las Vegas Golden Nugget Casino (calling it 'Nugget Hold'em'). Omaha hold 'em (also known as Omaha holdem or simply Omaha) is a community card poker game similar to Texas hold 'em, where each player is dealt four cards and must make their best hand using exactly two of them, plus exactly three of the five community cards. Player on the left wins with Three of a kind.

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