Silica-supported chromium oxide catalysts, also named Phillips chromium catalysts (PCCs), provide more than half of the world’s production of high- and medium-density polyethylenes. PCCs are usually prepared in the Cr(VI)/SiO2 form, which is subjected to reductive activation. It has been explicitly proven that CO reduces Cr(VI) to Cr(II) species that initiate ethylene polymerization; ethylene activates Cr(VI) sites as well, but the nature of the catalytic species is complicated by the presence of the ethylene oxidation products. It is widely accepted that the catalytic species are of a Cr(III)–alkyl nature, but this common assumption faces the challenge of “extra” hydrogen: the formation of similar species under the action of even-electron reducing agents requires an additional H atom. Relatively recently, it was found that saturated hydrocarbons can also activate CrOx/SiO2, and alkyl fragments turn out to be bonded with a polyethylene chain. In recent years, there have been numerous experimental and theoretical studies of the structure and chemistry of PCCs at the different stages of preparation and activation. The use of modern spectral methods (such as extended X-ray absorption fine structure (EXAFS), X-ray absorption near-edge structure (XANES), and others); operando IR, UV–vis, EPR, and XAS spectroscopies; and theoretical approaches (DFT modeling, machine learning) clarified many essential aspects of the mechanisms of CrOx/SiO2 activation and catalytic behavior. Overall, the Cosse–Arlman mechanism of polymerization on Cr(III)–alkyl centers is confirmed in many works, but its theoretical support required the development of nontrivial and contentious mechanistic concepts of Cr(VI)/SiO2 or Cr(II)/SiO2 activation. On the other hand, conflicting experimental data continue to be obtained, and certain mechanistic concepts are being developed with the use of outdated models. Strictly speaking, the main question of what type of catalytic species, Cr(II), Cr(III), or Cr(IV), comes into polymerization still has not received an unambiguous answer. The role of the chemical nature of the support—through the prism of the nature, geometry, and distribution of the active sites—is also not clear in depth. In the present review, we endeavored to summarize and discuss the recent studies in the field of the preparation, activation, and action of PCCs, with a focus on existing contradictions in the interpretation of the experimental and theoretical results.