Various methods and devices for inserting a guidewire into the body are provided. In one embodiment, a guidewire insertion device is provided and includes and outer sheath having an outer surface and an inner lumen extending therethrough, and a dilator having an inner lumen extending therethrough and having a length greater than a length of the outer sheath. A guidewire can be configured to extend through the inner lumen of the dilator such that the guidewire is removably and replaceably disposable within the dilator and coupled thereto. A locking mechanism can be effective to selectively configure the guidewire between a locked position in which the guidewire is stationary relative to the dilator and an unlocked position in which the guidewire is movable relative to the dilator.