Medium pairs — typically 66 through JJ — sit at an interesting point in a player’s range. They’re certainly not premiums, but they’re far too good to treat passively. These hands win a lot of small and medium pots when played well, yet they’re also responsible for many of the silent bankroll leaks you don’t notice until you review your long-term graph.
The biggest issue is that many players approach medium pairs with a “set-mining mentality,” regardless of stack depth, position, or opponent type.
That mindset works fine in extremely passive home games, but it breaks down quickly in tougher online environments where opponents apply pressure and edges are thinner. A profitable medium pair strategy requires far more nuance than simply hoping to flop a set.
Where Players Go Wrong With Medium Pairs
One of the biggest mistakes is homogenizing the entire category.
If you consistently treat JJ the same way you treat 77, you’ll end up in uncomfortable spots far more often than necessary. JJ plays extremely well as a preflop 3-bet, takes down many pots uncontested, and dominates weaker pairs. 77, on the other hand, often relies on reaching turns and rivers with a playable SPR and picking up backdoors or favorable boards.
Another common leak is calling far too often preflop. Tournament players in particular get attached to the idea of “pot control,” but this often gives opponents cheap entry into the pot, allows them to over-realize equity, and forces you into postflop guesswork. A well-timed 3-bet prevents all of that and allows your medium pairs to play from a position of strength instead of passively reacting.
There are situations where flatting is still ideal — such as facing a strong early-position open in a multiway-friendly spot — but as a whole, most players would see instant improvement simply by 3-betting with these hands.
Cash Games vs. Tournaments: Understanding the Shift
Cash games allow these hands to realize their full potential. With deeper stacks, you have enough maneuverability to play turns and rivers, extract thin value, and apply multi-street pressure. A hand like TT can turn into a three-street value hand against certain opponents, while 99 becomes a great candidate for floating on dry flops and picking up the pot later.
Tournaments, however, introduce far more constraints.
Medium pairs can go from clear value hands to borderline folds depending on stack depth, ICM pressure, and stage of the event. For example, TT plays beautifully as a 3-bet jam at 25bb, but becomes a cautious flat at a final-table bubble where shorter stacks still need to bust. These dynamic shifts are exactly why medium pairs separate technical players from intuitive ones.
A Professional Way to Categorise Medium Pairs
Strong players break medium pairs down into functional groups:
JJ–TT play comfortably as value hands that want initiative. They often win pots before the flop or through one well-timed continuation bet.
99–88 are flexible but sensitive to pressure. These are the pairs where understanding your opponent’s tendencies makes all the difference.
77–66 rely on playability, position, and favorable board textures. They suffer the most when SPR shrinks too quickly or when the opponent’s range remains uncapped.
A refined strategy isn’t about memorizing lines; it’s about understanding which type of medium pair you hold and how it functions in that specific context.
A Useful Outside Perspective
For players who want a deeper exploration of these dynamics, a helpful resource is Mike Waters’ full strategy guide on poker tournaments and cash games. It combines theoretical structure with in-game adjustments, breaking down how these pairs should be played across different formats and stack sizes.
Bottom Line
Medium pairs thrive when played with intention. They require thoughtful range construction, selective aggression, and an understanding of how initiative and stack depth shape their value.
If you treat them as a monolithic group, you cap your win rate. If you learn to categorize and adapt them, you unlock one of the most consistently profitable segments of your range — both in cash games and tournaments.