RTLinux is a real-time operating system that allows real-time applications to run on top of Linux. It modifies the Linux kernel to add a virtual machine layer with a separate task scheduler that prioritizes real-time tasks over standard Linux processes. This enables RTLinux to support hard real-time deadlines. Programming in RTLinux involves creating modules that can be loaded and unloaded from the kernel using specific commands. Real-time threads and synchronization objects like mutexes are implemented using POSIX interfaces.