Reverse osmosis (RO) is the main process of current industrial desalination, and its performance is affected by the quality of water source. Natural water contains a certain level of silica, which is originated from metal silicate in the earth crust. Due to its complexity, silica fouling is difficult to control, which often causes less efficient design of RO system for safe operation. In the present work, we review the current state of silica treatment technology in RO desalination. Silica chemistry is investigated in standpoint of the scale formation mechanism among multiple forms of silica species and its synergistic interaction with other foulants such as organic matter. Then, pretreatment methods to remove silica in the RO feed water are outlined. They include softening/coagulation, seed precipitation/aggregation, tight ultrafiltration, ion exchange, adsorbents media, and electro coagulation. We finally highlight the mitigation of RO fouling under silica rich conditions, whose concept can be implemented in different ways of antiscalant dosing, high/low pH operation, and intermediate softening of the RO concentrate, respectively. This review will provide comprehensive information and insight about the optimal operation of industrial RO susceptible to silica fouling.