A pill crusher device and method including a base and a lid movable between open and closed positions with respect to the base. The base includes a pill cup holder for holding a cup with one or more pills therein. The cup may include a flange that is keyed to the cup holder to prevent the cup from rotating with the cup holder. A head protrudes from the inside surface of the lid and is shaped to nest within the cup either directly against the pills, or against a second cup placed in the first cup with the pills located between the two cups.