Cauchy-like matrices arise often as building blocks in decomposition formulas and fast algorithms for various displacement-structured matrices. A complete characterization for orthogonal Cauchy-like matrices is given here. In particular, we show that orthogonal Cauchy-like matrices correspond to eigenvector matrices of certain symmetric matrices related to the solution of secular equations. Moreover, the construction of orthogonal Cauchy-like matrices is related to that of orthogonal rational functions with variable poles.