Personally I love it - I make most of my isk via reactions. Happy to share what I know. I net about 2-2.5B per month running 4 reaction poses, for 10-12 hours of work, spread out in daily bits. That's roughly 200M / hr of work, so better than most forms of PVE. The best part though is the work is very easy to do in small daily chunks while dual boxing, which is infinitely more tolerable than grinding missions. The biggest barrier is capital, not skills.
There are lots of good guides for the mechanics out there, per Cthulhu's post above. Below is what the guides generally don't tell you based on my year+ doing it.
Sorry for the wall of text. I'm a horribly verbose faggot.
Basic Requirements
1) Good amount of starting capital - 1-1.5B min, more like 2B really for a basic setup. This covers 2x Large towers (best to do this in pairs), some fuel, and the inputs. You probably really want a freighter too (700M or something).
2) You can only run reactions in 0.3 and below. Ideal is a 0.3 that borders high sec - like Оtsas. Howеver‚ everyone knows this, and every moon in these systems are typically taken. That said, many have been abandoned and the towers could be removed if you take the time.
3) If you don't setup in a system bordering high sec, next best is a low sec system with a station and you REALLY want a Jump Freighter. A JF makes this quite easy, but without it, you'll be using regular haulers and shit and the volume of fuel will drive you nuts after a month or two. JFs of course are pricey - 4B+ and moderate skill training requirements.
4) You must visit your towers just about every day. Most of the higher profit reactions fill in <48 hours - this means if you go 2 days without changing the diapers, your towers start eating inputs and producing output that has no where to go, burning isk fast. Bad.
5) The daily visit is only 15 mins or so. I run 4 reaction towers and empty all 4 in 15 mins max. Approx once a week you have to refill the inputs / fuel, and take your output to market. This takes ~1 hour or so, including afk hauling to Jita. All of this is done on alts though, so its very viable to dual box this while on an op or forming up or whatever.
6) You need at least one alt and an alt corp (must have own corp, not NPC corp, to anchor poses). Ideally you need three alts - one hauler / JF / tower guy, one Jita alt for selling the shit, and one cyno alt if you're using a JF.
7) The poses are pretty safe. No one bothers shooting large caldari poses much. I don't even put guns on mine any more, just some hardeners for dickstar purposes. The one time someone did try to extort me / shoot my poses, we raped his gang twice, ganked 3 of his caps and laughed our asses off.
8) To Steave's point, there is a moderate amount of risk. You need to either switch reactions based on what's most profitable and monitor closely, or have enough isk buffer to wait it out. However, the market has stabilized quite a bit since a year or so ago and most of the higher value reactions have enough margin that they don't stay negative for long.
Pros and Cons
Some people find the daily diaper change to be brutal and lead to burnout - requires you to carve a small chunk of time for eve every day no matter what. Оthеr people‚ like me, find it very eaѕy to spеnd 15 mins / day while a gang forms up or we're camping emptying silos to be WAY better than grinding missions / anoms / invention / .01 isk wars / trading.
Personally‚ my view iѕ thеre's so much waiting in Eve in general that making time for that 15 mins on an alt is a piece of cake. Trading is the only other isk source I've heard people talk about that can come close to the isk / hour with low effort. Well, I guess botting too. And Awoxing.