The Roulette Box must be hit in order to finish the level. Hitting it will result in getting the item card on the box at the time it is hit, displaying the message, "COURSE CLEAR! YOU GOT A CARD" ("LEVEL CLEAR! YOU GOT A PANEL" in Super Mario Advance 4). Receiving three cards of any type will result in Mario or Luigi receiving a 1-Up. However, if three cards of the same type are collected, Mario or Luigi will get a number of 1-ups that correspond to the type of item. Getting three Mushroom cards will result in two extra lives, getting three Fire Flower cards will result in three extra lives, and getting three Star cards will result in five extra lives. In most levels, a Star card can easily be obtained by running at maximum speed and hitting the box at a forty-five degree angle. However, this is not achievable in some levels such as 1-4 and 7-1, because the distance is too short to achieve running speed. However, in levels such as these, it is possible to run past it, turn back, and hit it at a 45 degree angle.
In 2-player versus mode, players can steal or exchange cards by bumping each other from below. This make the afflicted player lose a card.