Yes start over.

I mean, if money were no object, I might just gut the whole house and start over but that's not an option. So I'm trying to make the most of what I've got (this is one of 3 same-era bathrooms in the house but the main one guests use). So taking a full remodel out of the equation, I can either ignore it/live with it or...

Here's my living room and my kitchen (we replaced the formica countertops and fruit wallpaper backslash but kept the original cabinets - same idea, a bit of updating without full re-do but the bathroom might be a pig for which no lipstick would look good?). I generally like "safe" neutral (boring??) colors, especially blues and greens, classic vs trendy (because I can't keep up with the trends!), and more nature-y vs geometric patterns.

All the updates you suggested will be enough to take this into a fresh look. For the floor tile I would do a white penny tile. Paint the walls white as well. Then add in your sage green accents. I too love a neutral color palette. Here's some inspiration for you on updating the cosmetics of the bathroom and leaving the surrounding tile...

(penny tile floor)

(I would keep the mirror very simple in style, since the tile has enough personality)

(Some lighting ideas, keeping it simple, updated, with a subtle hint of retro)

After all those updates, I would take a step back and reassess to see if you need to update the vanity too. The main thing that bothers me is the door style on the vanity, but maybe with a fresh coat of paint, the other updates will distract the eye enough. Good luck!

Hope this helps!

I love those suggestions! Thank you!!!

I've been looking at the following styles (darker fixtures to draw attention away from the tiles) but do you think sticking with the brushed nickel/chrome is a better choice? Thanks!

I think dark fixtures would be a nice accent! You could incorporate it into your linens as well.

For the lighting fixture, I would go a bit more simple in design. You don't want to add too much contrasting personality. Everything else looks great though, especially love the faucet!

Good point! Too busy.

If you need tile check NEMO TILES in Jamaica Queens NY. They stock a lot of old color 4x4 tiles. They were used extensively in Queens, Brooklyn, etc.

Thank you! I wonder if they could tell me which exact color I need to match these??

You could look for a floor tile that includes some of the color of your wall tiles. Usually that era of bathroom had a matching mosaic floor tile. This is obviously pink but it is the style of tile you would find most often.

Perhaps you could find an updated version of that tile. I would stick with chrome hardware if you're going to embrace the period feel. You can find hardware of the same period as well. Check Rejuvenation for period correct hardware. https://www.rejuvenation.com/catalog/products/saturn-star-backplate?cm_ven=Google_PLA&cm_cat=Shopping&cm_pla=default&cm_ite=default&kwid=productads-adid^71367229236-device^c-plaid^80162671511-sku^C6315-adType^PLA

Lighting should be easy to find as well as a medicine cabinet. I'm not saying you need to go full tilt retro but some of the very modern lines of that period still translate today.

As for the baseboard heater, it's probably screwed into the wall. Mine were. You may find that you have a few screw holes that have to be patched. You could fill them and try to match a paint as closely as possible to cover them.