[5][6] Plans were announced in 1992 to build a prison on Red Onion Mountain, with cost of construction estimated at $52 million.

Critics of the prison have alleged that many inmates are sent to Red Onion not because they have committed severe crimes but because they broke rules at other facilities.

[11] A reported 173 of the prisoners in solitary confinement have been diagnosed with mental illnesses, and some contend that isolation exacerbates their conditions and limits their ability to get treatment.

[15][19] The reports also cite the use of firearms with live ammunition by guards (an unusual practice in American prisons), which has led to inmate injuries.

They are officially used to limit movement of prisoners who threaten themselves or others, but critics such as Amnesty International have argued that guards use them for punishment and torture.

[22] Kevin "Rashid" Johnson, prison artist and organizer, has for years reported multiple instances of brutality and mistreatment from officers.

[23][22] Advocates for Red Onion prisoners also note that the majority of those incarcerated are African Americans from Richmond or Northern Virginia, whereas most of the corrections officers are whites from Appalachia.

[26] Prison officials confirm that isolation is normal at Red Onion, but argue that they do not engage in the cruel practice known as "solitary confinement".

They also disagree with complaints about access and say that prisoners can receive visits from attorneys, and from family and friends for four hours a month.

Former VADOC director Ronald J. Angelone, during whose term (1994–2002) Red Onion was designed and opened, defended the supermax system as necessary to avoid violence, saying: "There is no Department of Corrections magic wand that makes them decent human beings while in prison.

"[27] Former Virginia state senator Kenneth W. Stolle, who served as chairman of the Virginia State Crime Commission, has argued that rehabilitation at Red Onion is less important because so many prisoners serve life sentences, saying: "If they're getting out, obviously we have a responsibility to make sure they at least have an opportunity to be functioning members of society.

[29] The Virginia Department of Corrections announced plans in March 2012 to review solitary confinement policies at Red Onion.

[12] On May 22, 2012, inmates in Red Onion began a hunger strike to bring "abusive prison conditions to light".

[33] Supporters of the strikers challenged these reports and contended that the prison has taken pains to isolate and silence strike leaders in order to discourage communication with the outside world.

[11] On May 25, 2022, DeAndre Gordon self-immolated in order to be transferred to a different prison due to racism and other abuses he suffered.

[34][35] On September 15, 2024, Ekong Eshiet and Trayvon Brown, two black inmates at Red Onion State Prison, set themselves on fire while in solitary confinement to demand an end to the unbearable isolation, racism, and brutality.