I vote for the patterned floor, but no wainscotting. The room is too small for that IMO despite the inspiration picture. Look at it this way, if you skip the wainscotting that is less expense and work for you. It's hard for me tell exactly what the colors are in the tile, but choose your vanity and wall color accordingly. The only thing I can't be sure of is whether this is going to fit with the style of the rest of your house.

Agree, it’s a small room do the patterned tile and then just paint. It will look great.

Here are a few pix of our Powder Room. We have dark blue textured wallpaper and a black vanity. Perhaps preview ideas for yours.

You might as well tell what the flooring will be outside the powder room.

Thanks for the feedback everyone. I really appreciate it.

I know the room is very small but I wanted to do the wainscoting to lighten things up a bit because there are no windows or natural light. I like the idea of wallpaper but have already bought the paint. Would it be too much to do the patterned floor, wainscoting AND a lighter wall paper just on the wall behind the sink/mirror? Also light or dark vanity if I go with the wainscoting?

Everdebs the flooring right outside the powder room is going to be dark brown hardwood.

Love the pattern tile. I did our powder room in BM Van Deusen Blue and love it. The wainscoting is a very traditional look, so I vote no on that. Pretty artwork is my suggestion. This is rental so I had some existing items such as flooring I could not change. I do love it. We did our dining room in it too. You will love it.

Be sure you have adequate lighting because the darker paint will tend to soak up the light you provide. I know of two dark bathrooms where you can barely see your reflection in the mirror due to that issue.

Do the patterned tile, a linen-look wallpaper halfway up the wall (or to wainscoting height) and put white trim at the top of the wallpaper to finish the look. Save the wall behind the sink for a tall mirror that almost reaches the ceiling and has an antique gold frame. Instant drama.

I‘d only consider wainscotting if room is large enough. Make sure vanity is same color so as not to break it up visually and then patterned tile will not feel too busy.

If concerned about room being too dark in general, use the blue on the vanity and a light wall color that coordinates with tile’s background.

I prefer the simplicity/lightness, without wainscotting, letting the brass fixtures, accents, lighting, and floor take center stage.