We review the detection history, observation, distribution, and reactivity of molecular ions in extraterrestrial space, with particular (though not exclusive) reference to interstellar monocations. The diversity of interstellar ion chemistry is highlighted with reaction examples, drawn from the authors' own laboratories and elsewhere, and attempt to provide an overview of this broad and increasingly divergent field. Emphasis is given to the role of ions in the synthesis of molecules, including their ability to catalyze the transformation of neutral molecules.