We present a fast and accurate analysis of double-negative materials (DNMs) with surface integral equations and the multilevel fast multipole algorithm (MLFMA). DNMs are commonly used as simplified models of metamaterials at resonance frequencies and are suitable to be formulated with surface integral equations. However, realistic metamaterials and their models are usually very large with respect to wavelength and their accurate solutions require fast algorithms, such as MLFMA. We consider iterative solutions of DNMs with MLFMA and we investigate the accuracy and efficiency of solutions when DNMs are formulated with two recently developed formulations, namely, the combined tangential formulation (CTF) and the electric and magnetic current combined-field integral equation (JMCFIE). Numerical results on canonical objects are consistent with previous results in the literature on ordinary objects. © 2011 IEEE.