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This is a Shadow Game played between Yami Yugi and Yami Marik. As each player's Life Points decrease, their respective hosts (Yugi Muto and Marik Ishtar) will have more and more of their body wiped out.
When a player loses, both spirit and host will be sent to the Shadow Realm. However, Yami Marik would not be sent to the Shadow Realm along with his "host's" spirit if he lost, since he was an alter ego that Marik created himself, whereas Yami Yugi is a completely different spirit living dependably inside Yugi's body with Yugi's own spirit.
Before the match begins, Kaiba gives Yugi a card which will help him win the duel, "Fiend's Sanctuary".