I'd add painted beadboard wainscoting, a pedestal sink, new wall sconces to either side of a wall mirror and an new tile floor. Choose a nice paint scheme and this will look like a million bucks.

Thank you for your suggestions. What color paint for the walls? To the left of the powder room is a tan living room and to the right is a sage green sunroom.

Paint your vanity a medium taupe gray color, or black, and find a fun wallpaper in a geometric pattern!
If you don't want to remove large mirror, build a frame around it to match vanity paint! Change your faucet to a brushed nickel and add a floating shelf above toilet with a pretty vase of flowers or something with some color.
If you want to redo the floors, go for it, but it doesn't look that bad. Just get a new rug.
Do keep in mind that black floors tend to show more dirt .....little harder to keep clean looking, but if you don't mind that, then go for it! :)
Powder rooms are so much fun to me! I think they should fun and nice and interesting!

example of gray vanity......before and after of old mirror,

Here's a couple of examples (the one pic has dark floors like you mentioned

If neutral is what your going for, Tavern Taupe by Sherwin Williams has been a great choice for us. Good Luck!

here's a black framed wall mirror and black vanity.....

Be sure to factor in additional storage ideas if you plan to upgrade to a pedestal sink. Here's a little background reading: http://www.blog.riverbendhome.com/pedestal-sinks-vs-vanity-sinks/

I usually like powder rooms to have an interesting floor. This floor looks tired, albeit in nice condition. What about swapping out and installing hardwoods for a uniform look. Anything can be converted to a vanity so let your creativity go wild and pick a fun theme/color/scheme for the powder room.

Additionally, check out marble and granite fabricators for their remnants. Since the vanity is not too large, you can often get a remnant piece (from a larger kitchen job) and usually they only charge you for the fabrication not the actual piece itself.

http://www.designersguild.com/fabric-and-wallpaper-showroom/view-all-collections/carnets-andalous-wallpapers/azulejos/azulejos-cobalt/#.UtWXBvAzGCo

I just love this wallpaper, would it work for you as a feature wall maybe?

Accent the main wall (Wallpaper or Stone) depends on the budget...def a ped sink!

Which would be my main wall, the one that you see from the hallway or the one that has the sink and toilet? Would it be the same tile that I put on the floor? Same question if I use wallpaper...

The one from the Hallway......depending on your taste....maybe a funky wallpaper....perhaps with a texture..( but easy to maintain....or a subtle stone....

I had the exact same setup for my powder room (placement of sink and toilet) and it was an easy switch to put sink on wall that faces you when you enter the bathroom and toilet to the right of the door facing the wall that the sink would be placed on. It so much better that way since nobody wants a toilet as the focal point.

if you would rather go with a textured wallpaper....look at grasscloth!

If you did like sabrinager and flipped toilet and vanity, you could do something fabulous on that facing wall.

Hi Sabrina: Good job.
I would like suggest you some bathroom vanity options for your powder room. They are functional, attractive and very contemporary. The Roma vanity is available in 40 inch and color espresso or lacquered in white, black or taupe. The Cuero vanity are made with genuine leather in front and it is available in 32 or 40 inch , white or black. All them are designed and manufactured in Spain.

sabrinager, would it be possible to post a picture of your flipped powder room? We never considered moving anything around. Interesting thought.

I did not take a before picture, but our bathroom looked exactly like yours. My husband and son thought the picture of yours was our old one when they walked by the computer! All we had to replace was one floor tile under the right front leg of the vanity. We also decided to put boxes of molding on the walls on either side of the sink and painted the whole bathroom a iridescent white. It turned out really well!

sabrinager; that is adorable!!!

http://www.alaricoutlet.com/bath-vanities/agami-al3

Dear Houzz Family,
Once again I need your advice. I have to return these wallpaper books this Saturday 6/21. Please let me know if you like any of these designs. It's for the same bathroom. (We move slowly :-/)

More pics

A fresh pop of color on the walls could go a long way. Also, many people now have tile on their walls as well. Think of something that adds texture and makes the room unique. This could be tile, paint, wall covering, etc.

What did you think of the wallpaper above, too blendy?

Bold colors, Google happy colors for small spaces and see what you find. You never know