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In Dilemma Express, one player takes on the role of the cart driver and must choose where to send a deadly, out-of-control cart. Every other player at the table is playing cards and arguing to convince the operator to spare their lives and condemn everyone on the other lane to horrific death by cart.
Each round, one player will take on the role of cart driver. This person will be the judge and choose which track the trolley will assassinate.
The other players are divided equally between the teams and each of them will have a role to play during the round.
To start, a player will randomly draw 3 Angel Leads, choose one to play at the table, then randomly reveal a 2nd Angel Lead from the deck to add to the lead. Another player will draw 3 demonic tracks, and choose to add one to the opposing team's track, in an attempt to sabotage it, and spare their own tracks. Finally, the player(s) will draw track modifiers to place on any track card on the table. They can play on their own lanes to tip the judge's scales, or they can play on their opponents to tip the judge's scales even further and assassinate their opponent's lane.
The judge will ponder this riddle and eventually decide to kill a lead. The piece that was spared is the winner of the round!
The game continues for a number of rounds predetermined by the number of players at the table.