Recent experiments on kagome metals AV3Sb5 (A=K,Rb,Cs) identify twofold van Hove singularities (TvHS) with opposite concavity near the Fermi energy, generating two approximately hexagonal Fermi surfaces – one electron-like and the other hole-like. Here we propose that a TvHS generates a novel time-reversal symmetry breaking excitonic order – arising due to bound pairs of electrons and holes located at opposite concavity van Hove singularities. We introduce a minimal model for the TvHS and investigate interaction induced many-body instabilities via the perturbative renormalisation group technique and a free energy analysis. Specialising to parameters appropriate for the kagome metals AV3Sb5, we construct a phase diagram comprising chiral excitons, charge density wave and a region of coexistence. We propose this as an explanation of a diverse range of experimental observations in AV3Sb5. Notably, the chiral excitonic state gives rise to a quantum anomalous Hall conductance, providing an appealing interpretation of the observed anomalous Hall effect in kagome metals. Possible alternative realisations of the TvHS mechanism in bilayer materials are also discussed. We suggest that TvHS open up interesting possibilities for correlated phases, enriching the set of competing ground states to include excitonic order.