We review the paradigm of quintom cosmology. This scenario is motivated by the observational indications that the equation of state of dark energy across the cosmological constant boundary is mildly favored, although the data are still far from being conclusive. As a theoretical setup we introduce a no-go theorem existing in quintom cosmology, and based on it we discuss the conditions for the equation of state of dark energy realizing the quintom scenario. The simplest quintom model can be achieved by introducing two scalar fields with one being quintessence and the other phantom. Based on the double-field quintom model we perform a detailed analysis of dark energy perturbations and we discuss their effects on current observations. This type of scenarios usually suffer from a manifest problem due to the existence of a ghost degree of freedom, and thus we review various alternative realizations of the quintom paradigm. The developments in particle physics and string theory provide potential clues indicating that a quintom scenario may be obtained from scalar systems with higher derivative terms, as well as from nonscalar systems. Additionally, we construct a quintom realization in the framework of braneworld cosmology, where the cosmic acceleration and the phantom divide crossing result from the combined effects of the field evolution on the brane and the competition between four and five dimensional gravity. Finally, we study the outsets and fates of a universe in quintom cosmology. In a scenario with null energy condition violation one may obtain a bouncing solution at early times and therefore avoid the Big Bang singularity. Furthermore, if this occurs periodically, we obtain a realization of an oscillating universe. Lastly, we comment on several open issues in quintom cosmology and their connection to future investigations.