Motivated by recent advances in solution methods for mixed-integer convex optimization (MICP), we study the fundamental and open question of which sets can be represented exactly as feasible regions of MICP problems. We establish several results in this direction, including the first complete characterization for the mixed-binary case and a simple necessary condition for the general case. We use the latter to derive the first non-representability results for various non-convex sets such as the set of rank-1 matrices and the set of prime numbers. Finally, in correspondence with the seminal work on mixed-integer linear representability by Jeroslow and Lowe, we study the representability question under rationality assumptions. Under these rationality assumptions, we establish that representable sets obey strong regularity properties such as periodicity, and we provide a complete characterization of representable subsets of the natural numbers and of representable compact sets. Interestingly, in the case of subsets of natural numbers, our results provide a clear separation between the mathematical modeling power of mixed-integer linear and mixed-integer convex optimization. In the case of compact sets, our results imply that using unbounded integer variables is necessary only for modeling unbounded sets.