Additionally, and here's the really tricky part, you must use exactly two cards in your hand and three cards on the board. There is both a high and low hand, with each winning half the pot.
The other major difference is on the showdown. The obvious difference is that each player is dealt four cards rather than two. The betting is similar and there's a flop, turn and river. On its face, O/8 looks quite a bit like Texas hold'em. O/8 is usually played using limit betting structures in live games but you can also find no-limit and pot-limit games online.
There is another variant played for high hand only and, while the mechanics are the same, the game plays much differently. Omaha high/low split, eight or better ( Omaha/8 or O/8 for short) is commonly found in larger brick and mortar card rooms as well as at all the major online rooms.