1565, St. Elmo's Pay is an asymmetric, competitive, tactical card game, and successor to the award-winning 1066, Tears to Many Mothers (also available in this campaign), with which it is fully compatible. Each player, as either Ottoman Turks or Knights of St John, musters troops and resources to overcome the various obstacles in their path before the two armies clash in an epic siege over three frontiers on the tiny island of Malta: Birgu, Senglea, and the doomed fortress of Saint Elmo.

Every beautiful card in the game is inspired by a real person or event from the time. With a focus on quick, tactical play and a thematic re-imagining of the events of the time, the game is non-collectable, and there is no deck building required. Each player simply grabs their deck and shuffles, then play begins.