The Van Hove singularity (VHS) provides a paradigm for the study of the role of peaks in the density of states (dos) on electronic properties. More importantly, it appears to play a major role in the physics of the high-Tc superconductors, particularly since recent photoemission studies have found that the VHS is close to the Fermi level in most of the high-Tc cuprates near the composition of optimum Tc. This paper offers a comprehensive survey of the VHS model, describing both theoretical properties and experimental evidence for the picture. Special topics discussed include a survey of the Fermi surfaces of the cuprates and related compounds, and an analysis of the reliability of the slave boson approach to correlation effects. While many properties of the cuprates can be qualitatively understood by a simple rigid-band-filling model, this is inadequate for more quantitative results, since correlation effects tend to pin the Fermi level near the VHS over an extended doping range, and can lead to a nanoscale phase separation. Furthermore, the peaks in the dos lead to competition from other instabilities, both magnetic and structural (related to charge density waves). A novel form of dynamic structural instability, involving dynamic VHS-Jahn-Teller effects has been predicted. Scattered through the literature, there is considerable experimental evidence for both nanoscale phase separation of holes, and for local, possibly dynamic, structural disorder. This review attempts to gather these results into a comprehensive database, to sort the results, and to see how they fit into the Van Hove scenario. Recent experiments on underdoped cuprates are found to provide a strong confirmation that the pseudogap is driven by a splitting of the VHS degeneracy.