A cash-out refinance can be really good if you're disciplined enough to use the extra cash for investment purposes and if the monthly cash flow supports the monthly payment.
Typically, I only refinance the amount owed, but that leaves untapped equity in the property.
However, once I did a major cash out refi in Memphis and it literally changed my life. I might do one again someday, but it'd probably be a once a decade kind of thing, I think.