One way of doing it would be with $push
:
db.col.update(
{ name: 'doc', 'list.id': 2 },
{$push: {'list.$.items': {id: 5, name: 'item5'}}}
)
http://docs.mongodb.org/manual/reference/operator/push/
You can also replace $push
with other operators like (possibly) $addToSet
to get the exact results you are looking for.