The fireplace is usually the focal point of the room. Its also an easy place to do an update.
Remember when television sets were way too big to go above a fireplace? Personally I prefer to not mount a flat screen above the living room fireplace but that's a good solution in a bedroom or family room. If possible run the coax cable and outlet so the TV will hide the connections--a much cleaner look than cords running down the side. Here's a cool cable management helper.
But if you can't get into the wall just keep the cords tidy try this paintable cord cover.
The area around the firebox is called the "face" of the fireplace. Often the face can be skim coated if the surface is rough and re-tiled with a mosaic or large format stone or ceramic tile. You can also paint over old red brick using water down acrylic paint or a slurry specified for natural stone and brick.
Adding a fresh coat of paint or stain to the legs and mantle will bring good results too. So don't be afraid to breath new life into that fireplace!