Both a cash-out refinance and a HELOC let you convert your home equity into cash, but they work very differently.
Cash-Out Refinance: You replace your existing mortgage with a new, larger loan. The difference between the new loan amount and your old balance is paid to you in cash. You end up with one loan at a new interest rate.
HELOC (Home Equity Line of Credit): A second loan that sits on top of your existing mortgage. It works like a credit card — you have a credit limit, draw from it as needed during the draw period (typically 10 years), and pay it back over the repayment period.