The Martian ionosphere originates from the ionization of the planetary neutral atmosphere by solar radiation. This conductive layer is embedded within the thermosphere and exosphere of Mars where it forms a highly variable interaction region with the solar wind. The Martian ionosphere has been continuously observed by the three plasma instruments MaRS, MARSIS and ASPERA-3 on Mars Express for the last 20 years ( >10 Martian years). Those long-term observations laid a solid foundation for what we know today about the Martian ionosphere, and provided numerous opportunities for collaboration and coordinated observations with other missions. This review describes the most significant achievements of Mars Express for the ionosphere, such as the dynamics and structures of both day and nightside, its variability and couplings with the lower atmosphere, as well as the improvement of atmospheric and ionosphere modelling. Mars Express has also provided a better characterization of the role of several external and internal drivers in controlling the ionosphere, such as the Martian crustal magnetic fields, solar activity, seasons, dust lifting from the surface, and even the direct interaction of the Martian ionosphere with the coma of an Oort-cloud comet (C/2013 A1, Siding Spring).