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Toe to Toe is an Action Card in Resident Evil: The Deck Building Game, specifically expansion set #3: Nightmare. The player who plays it gets to draw one card for every 5 cards in their inventory. It also grants the player an additional action and a gold cost of 70 to purchase.
The image shown on the card is taken directly from the knife-fight sequence between Leon and Krauser in Resident Evil 4.
Unsurprisingly, the card is very useful in the hands of Jack Krauser; specifically the second Krauser card from Alliance (based on his appearance from Darkside Chronicles). Krauser's Level 2 Ability states that he deals +5 Damage for every card in his hand. Keeping with Nightmare's emphasis on larger inventories, this card can allow Krauser to take on larger enemies despite being handicapped by his Level 1 ability (which states he can only use one weapon at any given time). Using this card alongside the Riot Shotgun guarantees killing Infected enemies with over 50 Health.
Though not always necessary, this card comes in handy the player is using Billy Coen. Billy's most effective weapon is the flamethrower, which thrives on the player having a larger discard pile. Drawing a lot of cards through the use of this Action is helpful enough, but upon discarding all of them, the flamethrower is given a huge boost in power (even more so with the Action Lone Wolf). Since Billy can use his Level 2 effect to retrieve any card from his discard pile, this also prevents the player from losing any Flamethrowers they acquire.
The first Claire Redfield card can also use this card to her advantage if both of her effects are in activated (giving +10 ammo and Gold to every ammunition card). The only problem is that large amounts of Gold are meaningless unless the player has multiple Buys.
A similar strategy is at work for any character that is lucky enough to be using the Gatling Gun. Claire especially can work wonders with this combination under the right conditions.