Abstract: A portable medical sharps disposal device and methods are disclosed including a container having an opening for receiving items including medical sharps for disposal. A reversible cap or lid covers the opening of the container in two different orientations, and locks with the container for disposal. The cap or lid may be provided as having a one side for use in an unlocked orientation, with the cap or lid having another side for use in a locked or sealed orientation. Various embodiments are disclosed in which the cover may be flipped over, rotated, or slid with respect to the opening of the container to facilitate the respective unlocked or locked orientations. The device may alternatively be provided with an indicator for showing when the cover is in the unlocked orientation or when the cover is in the locked.