Described is a needle assembly attachment and removal device comprising a case having a base and a longitudinal axis (L), a carriage axially movable with the case from a first position to a second position, a carrier rotatably coupled to the carriage and adapted to hold a needle assembly, and a gearing arrangement rotatably coupled to the carriage and adapted to rotate the carrier in a first rotational direction as the carriage moves from the first position to the second position and in a second rotational direction as the carriage moves from the second position to the first position.